[House Hearing, 110 Congress]
[From the U.S. Government Publishing Office]
LEGISLATIVE HEARING ON H.R. 1197, H.R. 3008,
H.R. 3795, H.R. 4274, H.R. 5155, H.R. 5448, H.R. 5454,
H.R. 5709, H.R. 5954, H.R. 5985, AND H.R. 6032
=======================================================================
HEARING
before the
SUBCOMMITTEE ON DISABILITY
ASSISTANCE AND MEMORIAL AFFAIRS
of the
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED TENTH CONGRESS
SECOND SESSION
__________
JUNE 12, 2008
__________
Serial No. 110-92
__________
Printed for the use of the Committee on Veterans' Affairs
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COMMITTEE ON VETERANS' AFFAIRS
BOB FILNER, California, Chairman
CORRINE BROWN, Florida STEVE BUYER, Indiana, Ranking
VIC SNYDER, Arkansas CLIFF STEARNS, Florida
MICHAEL H. MICHAUD, Maine JERRY MORAN, Kansas
STEPHANIE HERSETH SANDLIN, South HENRY E. BROWN, Jr., South
Dakota Carolina
HARRY E. MITCHELL, Arizona JEFF MILLER, Florida
JOHN J. HALL, New York JOHN BOOZMAN, Arkansas
PHIL HARE, Illinois GINNY BROWN-WAITE, Florida
SHELLEY BERKLEY, Nevada MICHAEL R. TURNER, Ohio
JOHN T. SALAZAR, Colorado BRIAN P. BILBRAY, California
CIRO D. RODRIGUEZ, Texas DOUG LAMBORN, Colorado
JOE DONNELLY, Indiana GUS M. BILIRAKIS, Florida
JERRY McNERNEY, California VERN BUCHANAN, Florida
ZACHARY T. SPACE, Ohio STEVE SCALISE, Louisiana
TIMOTHY J. WALZ, Minnesota
DONALD J. CAZAYOUX, Jr., Louisiana
Malcom A. Shorter, Staff Director
______
SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS
JOHN J. HALL, New York, Chairman
CIRO D. RODRIGUEZ, Texas DOUG LAMBORN, Colorado, Ranking
PHIL HARE, Illinois MICHAEL R. TURNER, Ohio
SHELLEY BERKLEY, Nevada GUS M. BILIRAKIS, Florida
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
__________
June 12, 2008
Page
Legislative Hearing on H.R. 1197, H.R. 3008, H.R. 3795, H.R.
4274, H.R. 5155, H.R. 5448, H.R. 5454, H.R. 5709, H.R. 5954,
H.R. 5985, and H.R. 6032....................................... 1
OPENING STATEMENTS
Chairman John J. Hall............................................ 4
Prepared statement of Chairman Hall.......................... 50
Hon. Doug Lamborn, Ranking Republican Member..................... 7
Prepared statement of Congressman Lamborn.................... 50
WITNESSES
Congressional Research Service, Library of Congress, Sidath
Viranga Panangala, Analyst in Veterans Policy.................. 17
Prepared statement of Mr. Panangala.......................... 70
U.S. Department of Veterans Affairs, Bradley G. Mayes, Director,
Compensation and Pension Service, Veterans Benefits
Administration................................................. 38
Prepared statement of Mr. Mayes.............................. 89
______
Alderson, Lieutenant Commander Jack B., USNR (Ret.), Ferndale, CA 26
Prepared statement of Lieutenant Commander Alderson.......... 83
Allen, Hon. Thomas H., a Representative in Congress from the
State of Maine................................................. 13
Prepared statement of Congressman Allen...................... 61
ALS Association, Jeff Faull, McEwersille, PA..................... 27
Prepared statement of Mr. Faull.............................. 85
American Ex-Prisoners of War, Les Jackson, Executive Director.... 22
Prepared statement of Mr. Jackson............................ 74
American Legion, Steve Smithson, Deputy Director, Veterans
Affairs and Rehabilitation Commission.......................... 23
Prepared statement of Mr. Smithson........................... 74
Bilirakis, Hon. Gus M., a Representative in Congress from the
State of Florida............................................... 9
Prepared statement of Congressman Bilirakis.................. 59
Filner, Hon. Bob, Chairman, Committee on Veterans' Affairs, and a
Representative in Congress from the State of California........ 5
Institute of Medicine of the National Academies, Judith A.
Salerno, M.D., M.S., Executive Officer......................... 16
Prepared statement of Dr. Salerno............................ 67
Rehberg, Hon. Denny R., a Representative in Congress from the
State of Montana............................................... 3
Prepared statement of Congressman Rehberg.................... 54
Space, Hon. Zachary T., a Representative in Congress from the
State of Ohio.................................................. 8
Prepared statement of Congressman Space...................... 56
Shea-Porter, Hon. Carol, a Representative in Congress from the
State of New Hampshire......................................... 11
Thompson, Hon. Michael, a Representative in Congress from the
State of California............................................ 2
Prepared statement of Congressman Thompson................... 51
Vietnam Veterans of America, John Rowan, National President...... 25
Prepared statement of Mr. Rowan.............................. 78
Veterans Affairs of Scott County, IA, David Woods, Director...... 30
Prepared statement of Mr. Woods.............................. 87
Wu, Hon. David, a Representative in Congress from the State of
Oregon......................................................... 12
Prepared statement of Congressman Wu......................... 60
SUBMISSIONS FOR THE RECORD
Hon. Michael L. Dominguez, Principal Deputy Under Secretary of
Defense for Personnel and Readiness, U.S. Department of
Defense, statement............................................. 94
Braley, Hon. Bruce L., a Representative in Congress from the
State of Iowa, statement....................................... 95
Disabled American Veterans, Kerry Baker, Associate National
Legislative Director, statement................................ 97
Fort McClellan Veterans Stakeholders Group, Susan R. Frasier,
Albany, NY, statement.......................................... 100
Lachapelle, Commander Norman C., MSC, USN (Ret.), Administrator,
Bureau of Environmental Health/Emergency Regional Response,
Memphis and Shelby County Health Department, TN, statement..... 104
National Association of State Directors of Veterans Affairs, John
A. Scocos, President, and Secretary, Wisconsin Department of
Veterans Affairs, statement.................................... 106
National Vietnam and Gulf War Veterans Coalition, Denise Nichols,
Vice Chairman, letter.......................................... 108
Olsen, John E., ET-2, USN, Billings, MT, statement............... 108
Paralyzed Veterans of America, statement......................... 111
U.S. Military Veterans with Parkinson's (USMVP), Alan Oates,
Edinburg, VA, Member, statement................................ 114
MATERIAL SUBMITTED FOR THE RECORD
Background, Followup Memorandum, and Administration Views:
Figure S-1, entitled, ``Roles of the Participants Involved in
the Presumptive Disability Decision-Making Process for
Veterans,'' and Figures S-2, entitled ``Proposed Framework
for Future Presumptive Disability Decision-Making Process
for Veterans,'' Excerpted from the Study entitled,
``Improving the Presumption Disability Decision-Making
Process for Veterans,'' 2008, by Committee on Evaluation of
the Presumptive Disability Decision-Making Process for
Veterans, Board on Military and Veterans Health, Jonathan
M. Samet and Catherine C. Bodurow, Editors, Institute of
Medicine of the National Academies......................... 118
Sidath Viranga Panangala, Analyst in Veterans Policy,
Congressional Research Service, to Kimberly Ross, House
Committee on Veterans' Affairs, Subcommittee on Disability
Assistance and Memorial Affairs, Memorandum dated October
21, 2008................................................... 120
U.S. Department of Veterans Affairs Views on H.R. 5954, a
bill to amend title 38, United States Code, to provide
veterans for presumptions of service connection for
purposes of benefits under laws administered by Secretary
of Veterans Affairs for diseases associated with service in
the Armed Forces and exposure to biological, chemical, or
other toxic agents as part of Project 112, and for other
purposes................................................... 121
Post-Hearing Questions and Responses for the Record:
Hon. John J. Hall, Chairman, Subcommittee on Disability
Assistance and Memorial Affairs, Committee on Veterans'
Affairs, to Hon. Michael L. Dominguez, Principle Deputy
Under Secretary of Defense for Personnel and Readiness,
U.S. Department of Defense, letter dated June 23, 2008, and
DoD responses.............................................. 123
LEGISLATIVE HEARING ON H.R. 1197, H.R. 3008,
H.R. 3795, H.R. 4274, H.R. 5155, H.R. 5448, H.R. 5454,
H.R. 5709, H.R. 5954, H.R. 5985, AND H.R. 6032
----------
THURSDAY, JUNE 12, 2008
U.S. House of Representatives,
Committee on Veterans' Affairs,
Subcommittee on Disability Assistance and
Memorial Affairs,
Washington, DC.
The Subcommittee met, pursuant to notice, at 2:10 p.m., in
Room 340, Cannon House Office Building, Hon. John J. Hall
[Chairman of the Subcommittee] presiding.
Present: Representatives Hall, Lamborn, Turner and
Bilirakis.
Also present: Representatives Filner, Space and Brown of
South Carolina.
Mr. Filner [presiding]. The Subcommittee on Disability
Assistance and Memorial Affairs of the House Veterans' Affairs
Committee is called to order. Unfortunately, if you have heard
the bells, we have three votes. Just for my colleagues, these
are the last votes of the day, so we will be back in about a
half hour. I apologize that with so many bills, we have to hold
you. We apologize, but we will be back right after the votes.
Mr. Thompson. Mr. Chairman, would you entertain a question?
Mr. Filner. Yes, sir.
Mr. Thompson. Would it be possible for Mr. Rehberg and I to
make our statement before we recess?
Mr. Filner. Yes, sir. With unanimous consent.
Mr. Lamborn. Absolutely.
Mr. Filner. So ordered. Thank you for the intelligent
suggestion.
Mr. Thompson. Thank you, Mr. Chairman. Each of us has an
airplane to catch to get home. So we appreciate it. Thank you.
Mr. Filner. Mr. Thompson will be recognized to talk on his
bill, which is part of a whole theme we are considering today,
and that is justice for veterans who have been lost through the
cracks.
Thank you, Mr. Thompson; thank you, Mr. Rehberg; thank you,
Ms. Shea-Porter, for your commitment to our veterans.
STATEMENTS OF HON. MICHAEL THOMPSON, A REPRESENTATIVE IN
CONGRESS FROM THE STATE OF CALIFORNIA; AND HON. DENNY R.
REHBERG, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MONTANA
STATEMENT OF HON. MICHAEL THOMPSON
Mr. Thompson. Thank you, Mr. Chairman and Members. The bill
that we have would grant presumption of a service connection
for veterans who have been exposed to dangerous chemicals or
biological agents as part of a test called Project 112 and
Project SHAD (Shipboard Hazard and Defense). These were Cold
war-era chemical and biological warfare tests that were
conducted on U.S. military personnel without their knowledge.
These ran from about 1962 to 1974, and these tests exposed
about 6,000 servicemembers to dangerous live agents such as VX
nerve agent, Sarin gas, and E. coli (Escherichia coli).
And as I said, for the most part these military personnel
were unaware they were being used in this test. And for nearly
30 years the Department of Defense denied that these tests ever
took place.
I have today with me, and you will hear from him later,
Jack Alderson, who is a constituent of mine, who brought this
issue to my attention in 1998. He is a former tugboat
commander, and he participated in these tests. He was the guy
in Project SHAD, and he will tell you how Project SHAD veterans
are routinely rejected by the VA for medical care and for
disability benefits.
You are also going to hear from Dr. Salerno from the
Institute of Medicine (IOM), who will testify that the study
that they did found no connection between these substances and
health problems with the SHAD veterans. I just want to be on
record as stating that that study that she is going to talk
about is terribly flawed.
I want to submit for the record, if I could, I think with
unanimous consent, the letter that Mr. Rehberg and I sent
regarding the flaws in this study. And I think that is
important.
They took 5 years to do this study. They still have work to
do, and these veterans can't wait any longer.
I also want to submit for the record a bibliography that
outlines all the citations. And I have them here, the
Subcommittee is welcome to them. Every blue tab on this sheet
indicates a scientific reporting of how these chemicals that
the IOM studied said didn't have any connection do, in fact,
have a connection. And I would like--I am willing to do just
the bibliography, but I will leave the whole package with you.
And thank you again for your help on this measure. And just
to reiterate, these veterans did everything they were asked for
from our country. They were exposed to dangerous chemicals.
They are sick. They are suffering as a result of this, and they
need our help. They can't wait another 5 years, they can't wait
another 40 years. They were literally lied to for 40 years as
to whether or not this project, this testing, took place and
the effect it has had on them. And I appreciate this
Committee's willingness to finally address the problems that
they are having. Thank you.
[The prepared statement of Congressman Thompson, and the
attached letter and bibliography, appear on p. 51.]
Mr. Filner. Thank you, Mr. Thompson. And your leadership on
this for so many years is greatly appreciated. I think we are
finally going to get justice for these veterans.
Mr. Rehberg, thank you for your participation, with Mr.
Thompson on this critical legislation.
STATEMENT OF HON. DENNY R. REHBERG
Mr. Rehberg. Thank you, Mr. Chairman and Members of the
Subcommittee. And I would really and sincerely like to thank
Mike Thompson, who has been a tireless advocate on this issue.
It has been my pleasure to work with him to bring these tests
to light and fight to get Project 112/SHAD veterans the
benefits they deserve.
When I was first elected to the House of Representatives in
2001, I was approached by Billings resident John Olsen. John
told me a disturbing tale of a government refusing to be
accountable for its actions, a long line of healthcare
problems, and a lack of care.
In the early Cold war era, as Mike had mentioned, the
Department of Defense and other Federal agencies conducted
these series of tests. They used VX nerve gas, Sarin nerve gas,
and E. Coli, and they were tested on unknowing military
personnel. John is one of those victims. Over the years he has
battled several health problems, including skin cancer,
prostate cancer, and an adrenal tumor the size of a fist.
Even worse, for more than 40 years the existence of these
tests had been denied by the Department of Defense, despite
reports from participating veterans like John that they were
being stricken with unusual diseases. During that time, many of
these veterans suffered and died while their government looked
the other way.
Finally, in 2001 the DoD did acknowledge that the tests
took place; however, the Veterans Administration still wouldn't
provide these veterans with health benefits and compensation
for their diseases. Instead, the VA commissioned the study.
We have problems with the study, as was mentioned before.
While working on this issue, I have been alarmed by the
deficiency of the program for notifying Project SHAD veterans
of their exposure. Due to pressure from the Congress, initial
search efforts began in 2000; however, they were and continue
to be inadequate, bordering on negligence. Since 2003, the
Department of Defense has stopped actively searching for
individuals who were potentially exposed to chemical or
biological substances during Project 112. At the same time, the
Department of Defense reported it had identified 5,842
servicemen and women, and estimated another 350 civilians were
exposed.
It is a true tragedy that our government, after exposing
these servicemen and women to a witches' brew of chemicals,
cannot be bothered to find and notify them of such. As I
mentioned earlier, the Department of Defense did identify
around 350 civilians that were potentially exposed; however, to
date no effort has even been made to notify these civilians.
This legislation will help set a standard of oversight for
the Federal Government's treatment of our soldiers. We can't
sweep the suffering of these veterans under the rug. We can fix
the problem created 40 years ago, and this legislation will do
that.
Again, thank you for allowing me this opportunity. With
unanimous consent, I would like to have John Olsen's testimony
submitted for the record, as well as the U.S Government
Accountability (GAO) Highlights that suggest DoD and VA need to
improve efforts to identify and notify individuals potentially
exposed during chemical and biological tests. It is not a
pretty report. It needs to be in the record. And they need to
do the right thing.
Thank you for your support of this legislation.
[The prepared statement of Congressman Rehberg, and the GAO
Highlights, appear on p. 54.]
Mr. Filner. So ordered on the submission of the testimony
and reports.
[The prepared statement of Mr. Olsen appears on p. 108, and
the other reports will be retained in the Committee files.]
Mr. Wu and Ms. Shea-Porter, we are going to take a 20-
minute recess to get our three votes in, and then we will be
back. I am sure you will join us, and we will hear your
testimony first when we return.
Mr. Wu. Thank you very much, Mr. Chairman.
Mr. Filner. Thank you very much, Mr. Thompson, Mr. Rehberg.
We will provide that justice.
We are recessed.
[Recess.]
OPENING STATEMENT OF HON. JOHN J. HALL
Mr. Hall [presiding]. Good afternoon. The Veterans' Affairs
Disability Assistance and Memorial Affairs Subcommittee
legislative hearing will now come back to order. I would ask
everybody to rise for the Pledge of Allegiance.
[Pledge of Allegiance recited.]
Thank you for your patience while we were across the street
voting.
First of all, I would like to thank all the witnesses for
coming, and apologize for my missing the earlier part of the
session when the Chairman of the full Committee, Mr. Filner,
graciously filled in for me.
Mr. Lamborn, our Ranking Member, will be back shortly, and
at that point he will give his statement.
We will try to move things along as quickly as possible as
we consider the 11 bills, 2 of which have already been spoken
on, H.R. 1197, H.R. 3008, H.R. 3795, H.R. 4274, H.R. 5155, H.R.
5448, H.R. 5454, H.R. 5709, H.R. 5954, H.R. 5985, and H.R.
6032. I left the titles out to keep it shorter, but we will
hear them as we approach each bill.
As a preliminary, it has already been granted, but I ask
unanimous consent that Mr. Filner, Mr. Brown, and Mr. Space be
invited to sit at the dais, which they have already done.
Without objection, they will be allowed to continue.
I know the many issues addressed in these bills are of
utmost importance to many of you in attendance today who, like
me, have constituents or loved ones who are directly impacted
by the problems they seek to solve.
Speaking of witnesses, I welcome you all who are here
today, including my fellow Members of Congress, I must express,
however, my disappointment that the DoD did not find it
``efficient'' to provide a witness to testify, particularly on
legislation that has clear DoD implications. Moreover, this
notice came late last week, after testimony was due, and after
the DoD had originally indicated that it intended to provide a
witness.
I hope to avoid this unnecessary wrangling in the future.
Our veterans should be important enough to every Federal agency
involved to send someone to testify. The nexus between the DoD
and VA are undeniable. Invitations to testify should not be
rebuffed by the DoD when we are attempting to examine issues
that overlap on jurisdiction and responsibility. I do note for
the record that yesterday DoD provided a written statement for
the record. This fact aside, Congress deserves the right to
question the appropriate DoD personnel in person, not just in
writing; not to mention that our men and women who have given
their all in service to our country deserve the right to have
their elected officials question the executive branch. This is
how our system of checks and balances must work to ensure our
democratic way of governing remains intact.
After our Ranking Member, Mr. Lamborn, returns we will
recognize him for his opening statement. And right now I would
like to recognize the Chair of the full Veterans' Affairs
Committee to speak on a bill of his, Mr. Filner.
[The prepared statement of Chairman Hall appears on p. 50.]
Mr. Filner. Thank you, Mr. Chairman. You have a big list of
bills. Thank you and Mr. Lamborn for taking up all of these
bills. I think there is a common theme of long-delayed justice
for veterans in all these, so I thank you for doing this.
In addition, you talk about how sad it is that the
Department of Defense did not send a witness. They did send a
witness to yesterday's full Committee hearing, at which the
Principal Deputy Under Secretary of Defense for Personnel
Readiness said, when confronted with the facts that several
hundred thousand of our Iraqi veterans and deployed troops have
PTSD--he said, no, they have symptoms of PTSD. And this is a
quote: Only a few have PTSD. And so that is what you get when
you get them here. An incredible, display of irresponsibility
from the executive branch.
Mr. Hall. Creative diagnosis.
STATEMENT OF HON. BOB FILNER, CHAIRMAN, COMMITTEE ON VETERANS'
AFFAIRS, AND A REPRESENTATIVE IN CONGRESS FROM THE STATE OF
CALIFORNIA
Mr. Filner. So even when you get them here, they say really
strange things.
I want to thank you for this panel today. I want to talk
about two bills: H.R. 3795, the ``You Were There, You Get Care
Act,'' which would help radiation-exposed veterans of the Gulf
War and subsequent conflicts; and, H.R. 6032, which would grant
a presumption of service-connection for Parkinson's disease for
Vietnam veterans.
I might say, since I see the national president of the
Vietnam Veterans Association here, we plan, at the full
Committee level, working with Mr. Hall, to actually take the
theme of ``You Were There, You Get Care Act'' for all of the
Agent Orange claims for Vietnam Veterans. I don't care if your
boots were not on the ground; you were in the blue water off
the shore, you were in the blue skies above Vietnam, it is way
past time for us to take care of all of those veterans, and we
hope we can do that.
Depleted uranium (DU), which is the subject of the first
bill, is an incredibly effective weapon, but its residue has a
half life of 4 billion years, and evidence indicates that it is
a carcinogen. We know that many health problems can result from
exposure to depleted uranium, and we know that if veterans have
been exposed, we have a responsibility to care for them.
The bill ``You Were There, You Get Care'' would ensure that
veterans who served in the 1991 Gulf War and subsequent
conflicts will be rated service-connected disabled for any
illnesses currently covered by the Radiation Exposure
Compensation Act, or RECA, passed by this Congress in 1990. The
bill will provide payments to individuals who contract cancer
and other serious diseases as a result of their exposure to
radiation from above-ground tests of nuclear weapons or from
employment in underground uranium mines, as well as any other
diseases found by the VA Secretary to result from depleted
uranium exposure.
If this bill is enacted, veterans serving in the Gulf War
1991 or those providing clean-up or servicing of vehicles or
equipment that had been in the Persian Gulf would be considered
exposed. If they become ill, this bill would ensure that the
illnesses would be deemed service-connected, and VA healthcare
and compensation would be provided.
Second, approximately 20 million gallons of herbicides were
used in Vietnam between 1962 and 1971 to remove foliage and
vegetation that provided cover for enemy forces during the
Vietnam War. Following their military service in Vietnam, some
veterans reported a variety of health problems and concerns due
to exposure to Agent Orange or other herbicides and pesticides.
My second bill, H.R. 6032 would establish a presumption of
service-connection for Parkinson's disease due to exposure to
Agent Orange for Vietnam veterans.
I was in Minnesota in Mr. Walz's district, last year, and
the Vietnam veterans group there gave me a list of hundreds and
hundreds of Vietnam veterans who had gotten Parkinson's in
their early fifties, way earlier than, the general population
typically becomes afflicted with this disease. It is clear
there is some connection here.
Although the Department of Veterans Affairs has developed a
comprehensive program to respond to the Agent Orange-related
medical problems, there is a lengthy list of diseases that are
service-connected under title 38, section 1116, which is
updated as evidence examined by the Institute of Medicine (IOM)
dictates, however, the list does not include Parkinson's
disease. Recently, the IOM's report indicated that the evidence
is insufficient to establish an association between Parkinson's
disease and the herbicides. But recently, two studies presented
to the Committee from Stanford University and the Iowa
Agricultural Health Study update of 2007 seem to indicate that
Vietnam veterans are more than two-and-a-half times more at
risk for contracting Parkinson's than the general population,
and connect Agent Orange to an increased likelihood of
contracting the disease.
I believe there is an association between the degenerative
effects of Parkinson's and Agent Orange, and I urge the IOM to
consider the findings of those studies. At the very least, as
pointed out by Chairman Hall, we need to examine the disconnect
between modern medicine and the current provisions under
section 1110, which only allow service-connection for chronic
conditions that manifest within 1 year of service. Modern
science clearly establishes that the symptoms of these many
degenerative diseases can take decades to onset.
So, I also look forward to exploring these discrepancies
and the issue of insecticide exposure during military spray
operations to control mosquitoes and to stop casualty rates due
to malaria, but then, have other unintended harmful effects.
Mr. Chairman, both these bills, H.R. 3795 and H.R. 6032,
would make a bold statement if enacted: When our men and women
volunteer for service or are drafted, they can count on their
government to compensate them and to care for them if their
service leads to illness.
I thank the Chair.
Mr. Hall. Thank you, Mr. Filner. You make a logical and
forceful argument for these bills.
Just to explain procedure, I am going to ask our Ranking
Member, the Honorable Mr. Lamborn, first for his opening
statement, and then the Members who are on the dais who have
legislation before us, and then the Members at the witness
table. So first Mr. Lamborn, you are now recognized.
OPENING STATEMENT OF HON. DOUG LAMBORN
Mr. Lamborn. Thank you, Mr. Chairman, and for yielding. I
thank you and your staff for scheduling this hearing today.
This afternoon we are considering several pieces of
legislation, all of which are of interest and potential value.
While I do have some policy concerns regarding a number of the
provisions, I am primarily struck by the mandatory offsets that
would be necessary to pass many of these bills under PAYGO
rules.
Mr. Chairman, as you know from the PAYGO problems with H.R.
5892, it is always a challenge to find offsets within our
jurisdiction, and that is something we need to keep in mind as
we examine these bills today.
The main policy concern I wish to express is that some of
the provisions before us are similar to section 101 of H.R.
5892 in that they would redefine ``combat with the enemy'' as
it pertains to section 1154 of title 38. Mr. Chairman, my
concerns with these types of provisions are not new to you or
other Members of this Subcommittee, and I will not reiterate
them here except to point out that a loose definition of
``combat'' would diminish the immeasurable sacrifice and
service of those who actually did face combat. While I
understand and appreciate the effort to address problems
regarding the VA claims backlog, I believe that they are
generally the result from procedural problems, and we should
address the problems accordingly.
On another note, I look forward to the testimony of the
representatives from the Institute of Medicine, IOM, who will
hopefully enlighten the Subcommittee about the process involved
in establishing a presumption of service connection for certain
illnesses and disabilities. Experts at VA and IOM have years of
experience in dealing with these issues, and I think it is
important for Congress to avail itself of their expertise
whenever possible.
Mr. Chairman, I again extend my thanks to you and your
staff for holding this hearing, and I look forward to hearing
the testimony of our colleagues and the other witnesses today.
I yield back.
[The prepared statement of Congressman Lamborn appears on
p. 50.]
Mr. Hall. Thank you, Mr. Lamborn.
The Chair recognizes Mr. Space for testimony on his
legislation.
STATEMENTS OF HON. ZACHARY T. SPACE, A REPRESENTATIVE IN
CONGRESS FROM THE STATE OF OHIO; HON. GUS M. BILIRAKIS, A
REPRESENTATIVE IN CONGRESS FROM THE STATE OF FLORIDA; HON.
CAROL SHEA-PORTER, A REPRESENTATIVE IN CONGRESS FROM THE STATE
OF NEW HAMPSHIRE; HON. DAVID WU, A REPRESENTATIVE IN CONGRESS
FROM THE STATE OF OREGON; AND HON. THOMAS H. ALLEN, A
REPRESENTATIVE IN CONGRESS FROM THE STATE OF MAINE
STATEMENT OF HON. ZACHARY T. SPACE
Mr. Space. Thank you, Chairman Hall, and thank you, Ranking
Member Lamborn, as well as the Members of the Subcommittee, for
providing me with the opportunity to speak in favor of H.R.
5709, the ``Veterans Disability Fairness Act.''
At the end of last year, the Oversight and Investigations
Subcommittee held a hearing on an Institute for Defense
Analysis (IDA) report regarding the average disability payments
received by veterans in each State. The hearing revealed that
the VA's current data is lacking, and that regional cultures
may be partly to blame for similarly disabled veterans
receiving different ratings, and thus different disability
payments.
I introduced legislation specifically geared to correct
these discrepancies. ``The Veterans Disability Fairness Act''
requires the VA to collect and monitor regional data on
disability ratings. It requires the VA Secretary to conduct
reviews and audits of the rating system. It requires the VA to
submit a report on an annual basis to Congress to track the
progress of the program. And it requires VA raters to take
ownership of their ratings by assigning identification codes to
all adjudications. The performance of specific raters will be
then evaluated periodically for consistency and accuracy.
The current short-changing in ratings is not reflective of
our heroes' service, and there is no reason that a veteran from
one State should receive less than veterans in other States.
This legislation is an important step in addressing these
issues and in providing needed oversight.
Additionally, H.R. 5709 supplements this Subcommittee's
work on Chairman Hall's 5892, the ``Veterans Disability
Benefits Claims Modernization Act.'' Section 106 of that bill
calls for an annual assessment of the quality assurance program
that examines data from regional offices (ROs), the accuracy of
evaluated claims, and creates automated, categorizable data to
better identify trends. My bill will require accountability by
enabling the specific identification of potentially problematic
claims raters who may knowingly manipulate claims.
Alternatively, this legislation will protect those claims
raters who are doing their jobs with integrity.
This bill is incredibly important to the veterans of Ohio.
Our State was ranked dead last in average disability payments,
and I cannot stand for this. According to the IDA report, the
national average disability payment is $8,890. Ohio's average
is $7,556. New Mexico, which had the highest in the country, is
on average $12,395 annually. You can see that that is a
significant discrepancy. And I believe that we must act to
restore parity to the disability payment system to ensure that
each veteran receives the full benefit of what he or she was
promised. Senator Sherrod Brown, also of Ohio, and also a
Member of the Senate Veterans' Affairs Committee, agrees, and
he has introduced identical companion legislation in the
Senate.
I would like to thank you once again, Chairman Hall, along
with Members of the Subcommittee for their consideration of
H.R. 5709, and I am grateful for the opportunity to present
this important piece of legislation. Thanks.
[The prepared statement of Congressman Space appears on p.
56.]
Mr. Hall. Thank you, Mr. Space. We will give it every
consideration, and the other panels will, I am sure, have
comments to make on your bill, as well as the others before us
today.
The Chair would now recognize Mr. Bilirakis for 5 minutes
to testify on his bill.
STATEMENT OF HON. GUS M. BILIRAKIS
Mr. Bilirakis. Thank you so much.
I would like to start by thanking you, Chairman Hall and
Ranking Member Lamborn, for including my legislation, H.R.
1197, on today's hearing agenda. ``The Prisoners of War Benefit
Act'' is a bill that my father, Congressman Mike Bilirakis,
first introduced several Congresses ago. He was able to make
some progress on this legislation before he retired in 2006,
and I am pleased to be continuing his efforts on this important
issue in the 110th Congress.
``The Prisoners of War Benefits Act'' is intended to
improve the benefits currently available to former POWs. In
1981, Congress established several service-connected
presumptions for certain medical conditions that affect former
prisoners of war. However, because of a very high level of
research certainty, 95 percent was required before establishing
presumptive status, many other medical problems common in POWs
have been excluded.
My legislation establishes service-connected presumptions
for two additional medical conditions, Type 2 diabetes and
osteoporosis. My staff has worked with the American Ex-
Prisoners of War to identify these conditions as having strong
evidence of a relationship between the POW experience and the
onset of the disease.
Congress has passed legislation giving the Department of
Veterans Affairs specific standards for determining whether the
addition of new presumptive diseases for Vietnam and Gulf War
vets is warranted. These standards require a positive
association for the adoption of a presumptive condition.
However, Congress has not established a process for VA to add
to the list of former POW presumptive diseases established in
1981.
In 2001, the VA Advisory Committee on Former Prisoners of
War recommended the burden for establishing POW presumptions be
adjusted to match the standards used for other beneficiary
groups. Therefore, H.R. 1197 includes a provision to establish
a process by which the VA could determine future presumptive
conditions for former POWs when there is a positive association
between the experience of being a prisoner of war and the
occurrence of a disease or condition. Under my legislation, the
VA's Secretary would have to review the recommendations of the
Advisory Committee on Foreign Prisoners of War and all other
sound medical and scientific evidence, attachment, and analysis
available when making this determination.
Under current law, to be eligible for disability
compensation for certain conditions presumed to be service-
connected for former POWs, a veteran must have been held in
captivity for 30 or more days. At the time when some of the
original POW presumptions were enacted, short-term prisoners of
war were unusual. Prisoners of war from more recent conflicts
have been confined for shorter periods of time. H.R. 1197 would
remove the 30-day minimum requirement, making all former POWs
eligible, regardless of how long they were held captive. This
provision is based on the recommendations of the VA's Advisory
Committee on Former Prisoners of War, which concluded in 2001
that this 30-day requirement should be repealed.
The 108th Congress did enact a partial repeal of the 30-day
minimum requirements as part of the Veterans Benefits Act of
2003. Specifically, this law eliminated the requirement that a
POW be held for 30 days or more to qualify for presumptions of
service connection for certain disabilities. Although I am
pleased the Congress took this initial step, I believe that
more can be done in this regard, and urge my colleagues to
support H.R. 1197 for this reason.
Before I close, Mr. Chairman, I would like to mention how
pleased I am that we have also included H.R. 5454 to today's
agenda. H.R. 5454, I believe sponsored by Representative Brown,
which I have cosponsored as well, would establish a presumption
of service connection for amyotrophic lateral sclerosis (ALS).
I have heard from some of my constituents whose loved ones
suffer from this devastating disease. They firmly believe there
is a link between their loved one's military service and their
developing ALS.
In closing, Mr. Chairman, I want to thank you once again
for including my bill in today's hearing. I hope that you and
our other Members, our other colleagues on the Subcommittee,
will support H.R. 1197 and H.R. 5454. I look forward to hearing
the testimony from today's witnesses.
Thank you, Mr. Chairman. I appreciate it.
[The prepared statement of Congressman Bilirakis appears on
p. 59.]
Mr. Hall. Mr. Bilirakis, thank you very much for your
eloquent testimony on behalf of those bills, and we will hear
testimony from our other panels soon about them.
But first we will turn to our fellow Members of Congress,
starting with the Honorable gentlelady from New Hampshire, Ms.
Carol Shea-Porter, speaking on her bill, H.R. 5155.
STATEMENT OF HON. CAROL SHEA-PORTER
Ms. Shea-Porter. Thank you, Chairman Hall and Ranking
Member Lamborn, for taking up my bill, H.R. 5155, the ``Combat
Veterans Debt Elimination Act.'' I am honored to testify before
you today on behalf of our servicemembers and their families.
Our soldiers, sailors, airmen, Marines and Coast Guardsmen are
on the frontline of this generations' struggle against
terrorism. Our Nation's bravest have answered the call, and in
towns and villages around the world they are stepping into the
breach to secure freedom, preserve liberty, and provide relief.
Tragically, some die in service to our country. Mourning
our fallen is a difficult and somber reminder that we are in a
state of persistent conflict. For some families, though, the
mourning process has been interrupted by an unfortunate
bureaucratic procedure. Under Title 38 of the U.S. Code, the
Veterans Administration is required to collect certain debts
from the estates of servicemembers killed in combat. That
procedure is wrong, and this bill is its best and only remedy.
These collections, while not common, are unacceptable, and I
believe an unintended consequence of a poorly drafted policy.
This fix is simple, appropriate, and necessary. When our
servicemembers give their last full measure of devotion, their
sacrifice should have had no price tag. No debt is larger than
the one we owe to our Nation's heroes and their families. ``The
Combat Veterans Debt Elimination Act'' ends the Title 38
requirement, and today we take the first step toward making
this right.
It is my firm belief that the VA and I agree on the intent
of my legislation, and I expect that they will share those
views later in this hearing. I am committed to working with the
VA and with the Committee to ensure it provides a proper remedy
to this problem without delay. Our interests and our goals here
are the same. Together we can agree to right this wrong and
prevent further attempts to collect these small, insignificant
debts that amount to little more than a rounding error, roughly
50 cents to every $30 million spent by the Federal Government,
a mere pittance unless you are one of these family members.
This country has made a promise to our servicemembers to
honor their sacrifice and to care for their families while they
do the work of our Nation. This Committee and this Congress
have made tremendous steps toward fulfilling these promises.
Today we continue that forward progress.
I thank you again for this opportunity to testify before
the Subcommittee.
Mr. Hall. Thank you, Ms. Shea-Porter. I appreciate your
thoughtful presentation about this very worthy piece of
legislation.
Next the Chair recognizes the Honorable gentleman from
Oregon, Mr. Wu.
STATEMENT OF HON. DAVID WU
Mr. Wu. Thank you, Chairman Hall, and Ranking Member
Lamborn and distinguished Members of the Subcommittee, for the
opportunity to testify today on behalf of my bill, H.R. 3008,
the ``Rural Veterans Services Outreach and Training Act.''
A few years ago I was made aware of a problem that directly
affects millions of individuals who have defended our country.
Due to budget cuts in many areas, including my home State of
Oregon, county veterans service officers are not being funded
at adequate levels. County veterans service officers provide
veterans with advice, support, casework service, and other
services about their VA benefits. There is a singular need for
these services in our rural communities.
There are approximately three million veterans living in
rural areas in the United States. A 2004 report published in
the American Journal of Public Health shows that veterans in
rural areas are in poorer health than their urban and suburban
counterparts. Without access to casework services, these
veterans go without all the benefits they need, deserve, and
have earned.
Some may argue that veterans in rural areas can simply
drive to the nearest VA regional office, but for many veterans
and their caregivers, this is impractical. According to the
National Rural Health Association, the average distance a rural
veteran must travel to get care is 63 miles. For someone who
has endured the trauma of a battlefield injury and begun the
long, arduous process of rehabilitation, this is often simply
too much to ask.
Without access to a county veterans service officer,
veterans must rely solely on customer service representatives
over the telephone or the Internet in order to access their VA
services. But anyone who has ever encountered an automated
phone system knows how frustrating and discouraging this can
be.
Veterans who have suffered physical, emotional, or
psychological injuries should not be forced to navigate the VA
bureaucracy alone because they do not live near a VA Regional
Office. Our veterans deserve better, have earned better, and
will get better under this bill.
County veterans service officers provide rural communities
with more than just their expertise. I believe our veterans are
best served by their fellow community members. Community
members understand a veteran's needs as they relate to his or
her community, job, and family and associated circumstances.
Armed with this attachment, county veterans service officers
can best advocate for the veterans they serve.
With this in mind, I introduced the ``Rural Veterans
Services Outreach and Training Act,'' which seeks to improve
outreach and assistance to veterans and their families residing
in rural areas. This bill establishes a competitive grant
program at the Department of Veterans Affairs to help eligible
States hire and train county veterans service officers for
their own rural communities. The Rural Veterans Outreach and
Training Act targets grant money to the communities that need
it the most. This legislation requires that grants will be used
only to supplement non-Federal funding sources, not supplant
them.
We have an obligation to ensure that veterans, wherever
they reside, have access to the services they have earned and
deserve. Our men and women in uniform give so much in service
to our country, and I believe we should act accordingly to
ensure that they have access to local assistance to find the
help they need. Again, I appreciate the Subcommittee's
consideration of the Rural Veterans Services Outreach and
Training Act, and on behalf of a grateful Nation and veterans
everywhere, I look forward to working with you on this
important legislation.
[The prepared statement of Congressman Wu appears on p.
60.]
Mr. Hall. Thank you, Mr. Wu.
As one who represents a district that is in New York, which
people think of as concrete and skyscrapers, but nonetheless
has within it Orange County, the black dirt farmers and vast
stretches of rural landscape stretching toward the Delaware
River, I can identify, and my veterans can identify, with the
problems you described.
We will now turn to Mr. Allen for testimony on his
legislation.
STATEMENT OF HON. THOMAS ALLEN
Mr. Allen. Thank you, Chairman Hall and Ranking Member
Lamborn, for holding this hearing. I am grateful for the
opportunity to testify on my bill, which is H.R. 5448, the
``Full Faith in Veterans Act.''
What we now know as post traumatic stress disorder, or
PTSD, is not a new phenomenon. The enormous stress of military
service has long been recognized as the source of disabling
psychological and emotional illness for many veterans.
Unfortunately, as I have learned from Maine veterans, proving
that PTSD is connected to service can be very difficult, and
denial of service connection leaves these veterans without
access to VA health benefits or disability compensation.
The goal of my bill is to ensure that every veteran whose
PTSD resulted from their service receives treatment and, if
appropriate, disability compensation. Too often veterans with
legitimate claims are met with skepticism and red tape. The
story of one of my constituents highlights this problem.
Terry Belanger is an Army veteran from Biddeford, Maine.
During his service from 1969 to 1970, his supply vehicle came
under enemy fire, he reports, practically every night. Close
friends were killed in combat, another died in a stabbing. He
witnessed the torture of Viet Cong officers, and he saw the
truck ahead of his strike a mine. On one mission a young
Vietnamese girl suddenly appeared in front of his truck, and
his vehicle ran over the little girl, apparently killing her.
Because his convoy was under fire, he could not stop. Terry's
nightmares about this incident resurfaced years ago, after he
nearly struck another child who darted in front of his car.
When he returned from Vietnam, Terry was diagnosed by
healthcare professionals as suffering from severe PTSD
resulting from his service in Vietnam. In 1989, he filed a
claim with the VA for service-connected PTSD. The claim was
denied due to, and I am going to quote, lack of credible
attachment of supporting stressors. For years Terry tried to
get the Army to search for documents that would prove that
these stressors had occurred. In 1993, the National Personnel
Records Center basically told Terry to forget it because the
requested records, quote, would rarely show specific details
about a unit's activities and movements. They say the agency,
quote, was unable to perform the extensive research requested
due to staffing and budget limitations.
But Terry continued the fight. Finally, in 2005, the
National Archives found documents that verified that Terry's
unit was in combat for months, but it took another 3 years for
the VA to actually approve his claim, which they finally did a
few weeks ago, 19 years after the claim was first filed.
Under current law, the veteran bears the burden of
producing documents to prove the trauma occurred. How is Terry
Belanger supposed to find the records if the government
couldn't? In these cases, when no records can be found to
substantiate the claim, a veteran can also submit two buddy
statements as evidence their claimed stressor actually
occurred, but this is no easy task. Many veterans magazines
contain ads like this one in the April 2008 issue of VFW
magazine. The ad reads, 173rd Airborne Support Battalion, An
Khe, Vietnam, 1968-69, seeking anyone who attended Airborne
Jungle School when one of the instructors was accidentally shot
by one of the other instructors next to me. Anyone there when
the school and mess hall were shelled and three people were
killed. Need substantiation for PTSD claim. William E. Young,
Jr.
Veterans should not have to take out classified ads in
order to have their claims for PTSD approved by the VA. In
Terry's case, doctors confirmed he had PTSD. His nightmares and
flashbacks referred to his time in Vietnam. His government
trusted him when he served his country. Why should we distrust
him now?
Under my bill, if a veteran is diagnosed by a certified
mental health professional as suffering from PTSD relating to
the veteran's military service, the VA must accept this finding
as sufficient proof of service connection. The VA can rebut
this finding of service connection by clear and convincing
evidence to the contrary. The bill would ensure that the VA
does a better job at diagnosing and treating this debilitating
disorder.
A broad array of veterans groups, including Veterans for
Common Sense, Swords to Plowshares, and the Maine departments
of the American Legion, AMVETS, the DAV, and the Veterans of
Foreign Wars, along with Maine's Bureau of Veterans Services
support my bill.
For too long America has neglected our responsibilities to
the men and women who carry the emotional scars that military
service sometimes brings. Terry Belanger's wife wrote, ``This
wonderful man left part of his soul in Vietnam.'' I hope and
pray that with care and support, Terry and other veterans
suffering from PTSD will be restored to full and productive
lives. The Full Faith in Veterans Act can help achieve this
goal.
I thank the Subcommittee for the opportunity to testify,
and would be happy to answer any questions.
[The prepared statement of Congressman Allen and
attachments appear on p. 61.]
Mr. Hall. Thank you, Mr. Allen.
I sympathize and agree wholeheartedly with the intent and
the content of your bill. In terms of this presumptive
stressor, which includes, among other things, PTSD, it may go
beyond and be more thorough than the Disability Claims
Modernization Act, H.R. 5892, which we approved out of the
Subcommittee and the full Committee a few weeks ago.
The most dramatic case that my staff and I encountered was
a World War II veteran who came to us 60 years after he had
been swimming in the Pacific Ocean for the second time, after
two ships were blown out from under him in World War II. He had
started trying in his seventies to get some kind of help for
his emotional problems with the flashbacks and the depression
and the inability to lead a normal life. Fortunately, he lived
long enough that we were able to get him a correct diagnosis.
The VA had diagnosed him as schizophrenic with a preexisting
condition, meaning when he signed up at age 18, he must have
been schizophrenic, but they didn't notice it. We got that
turned into 100 percent PTSD classification just last year.
So it is true this applies to any war; especially the wars
in Afghanistan and Iraq, where the enemy is not in front of you
and your support team behind you. It is sort of everybody is
everywhere. And as in Vietnam, it is difficult to tell those
who were working with you, be they translators or logistical
people, from those, for instance in Iraq, who may turn on you
with a bomb or a weapon at any time.
So the stress--whether it is immediate or post traumatic
stress--is real, and I congratulate you and commend you for
your legislation.
I am going to hold off on questions myself. Other Members
of the Committee, would you like to question this panel? If
not, we will excuse you. I know you have trains and planes and
other modes of transportation to catch. I thank you so much for
your legislation. We will be hearing testimony on it from our
next panels.
Congressman Wu, Congressman Allen, thank you very much.
Mr. Allen. Thank you, Mr. Chairman.
Mr. Hall. We will ask our second panel, Judith Salerno,
M.D., M.S., Executive Director of the Institute of Medicine,
National Academy of Sciences; Sidath Viranga Panangala, Analyst
of Veterans Policy for the Congressional Research Service;
Christine Scott, Specialist, Social Policy, Congressional
Research Services (CRS); and Douglas Weimer, Legislative
Attorney for the Congressional Research Services, Library of
Congress.
Thank you for joining us. Thank you for your patience. As
usual, your written statement is entered into the record. So
feel free to shorten it if you want, or embellish upon it if
that is what you prefer.
We will begin with Ms. Salerno. You are recognized for 5
minutes.
STATEMENTS OF JUDITH A. SALERNO, M.D., MS, EXECUTIVE OFFICER,
INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES; AND SIDATH
VIRANGA PANANGALA, ANALYST IN VETERANS POLICY, CONGRESSIONAL
RESEARCH SERVICE, LIBRARY OF CONGRESS; ACCOMPANIED BY CHRISTINE
SCOTT, SPECIALIST IN SOCIAL POLICY, CONGRESSIONAL RESEARCH
SERVICE, LIBRARY OF CONGRESS; AND DOUGLAS WEIMER, LEGISLATIVE
ATTORNEY, CONGRESSIONAL RESEARCH SERVICE, LIBRARY OF CONGRESS
STATEMENT OF JUDITH A. SALERNO, M.D., MS
Dr. Salerno. Good afternoon, Chairman Hall and Members of
the Subcommittee. My name is Dr. Judith Salerno, and I am the
Executive Officer of the Institute of Medicine. I am also
honored to have served veterans for nine years while in the
Veterans Health Administration.
I am here today to address topics that are pertinent to
several of the bills that are being discussed, the topics
covered in seven reports that are authored by Committees of
experts convened by the Institute of Medicine. The reports are
part of a long history of the IOM applying its expertise to
assist the Department of Veterans Affairs by evaluating
scientific evidence in a fair and unbiased manner, and drawing
conclusions regarding health effects associated with exposures
experienced by our Nation's veterans.
My written testimony provides greater detail on all of the
studies that I will summarize today. The first three studies I
will discuss are Congressionally mandated, and ask the IOM to
examine health outcomes related to exposures during the Vietnam
and Gulf wars. H.R. 3795 would add a presumption of radiation
exposure for the purposes of service connection for veterans of
Gulf war and subsequent conflicts in that theater. The bill
also calls for an independent study to determine diseases that
may have resulted from these exposures.
H.R. 6032 would provide presumption of service connection
for Parkinson's disease for Vietnam veterans exposed to
herbicides. IOM expert Committees concluded that there was no
evidence to either support or rule out an association with
numerous health outcomes related to depleted uranium and, in
the case of Parkinson's, for exposure to herbicides which were
used in Vietnam. The IOM is currently conducting an update of
its 2000 report on DU. It is expected to be released this fall.
And the Parkinson's update is due in 2009.
With regard to H.R. 5454, the IOM expert committee examined
the available scientific literature on ALS and veterans, and
that report was released in 2006. Only five studies on the
topic were identified. The Committee found that there was
limited or suggestive evidence of an association between
military service and the development of ALS.
The next three reports generally covered disability and
compensation issues. H.R. 1197 addresses issues related to the
establishment of presumptions of service connection. A 2008 IOM
report proposes an alternative scientific framework for making
decisions regarding service compensation. Its findings and
recommendations were previously delivered to the Subcommittee
in February, and in the interests of time, I won't repeat these
findings here.
H.R. 5448 includes provisions for VA to update the rating
criteria used to evaluate PTSD for compensation purposes, and
to create a training and certification program for VA employees
who perform the ratings.
Last year an IOM Committee identified areas where changing
current practice could result in more consistent and accurate
ratings for disability associated with PTSD. The Committee
found that the current criteria are overly general for the
assessment of PTSD, and recommended that new criteria be
developed and applied specifically to PTSD symptoms, and that
these be grounded in the standards set out in the Diagnostic
and Statistical Manual of Mental Disorders IV, which is used by
most mental health professionals.
The Committee also recommended that VA establish a
certification program specifically for raters who deal with
PTSD claims, with the training to support it, as well as
periodic recertification.
H.R. 5709 would require annual reviews of the accuracy and
consistency of decisions on disability compensation. This
report recommended periodic evaluations of the accuracy,
validity, and inter-rater reliability of ratings across all 58
VA field offices and body impairment categories.
The main finding of this report, however, was that the VA's
schedule for rating disabilities is badly out of date, and
recommended that VA update the ratings schedule using current
medical knowledge.
Finally, H.R. 5954 would establish a mechanism for
determining presumptive service connection for diseases that
could be related to participation in Project 112, which
includes Project SHAD. The 2007 report on Project SHAD found no
clear evidence that specific long-term health effects were
associated with the participation in Project SHAD; however,
because of the limitations of the studies, in response rates,
and the size of the study, the report's finding should not be
viewed as clear evidence that there are no possible long-term
health effects related to SHAD involvement.
The Institute of Medicine is pleased to have assisted VA
and Congress with its expert evaluations. We hope that we have
contributed to improving care for our Nation's veterans. Thank
you for the opportunity to address the Subcommittee. I would be
happy to take any questions.
[The prepared statement of Dr. Salerno appears on p. 67.]
Mr. Hall. Thank you so much for your testimony, Ms.
Salerno.
Next, Mr. Sidath Viranga Panangala. Is that close to the
pronunciation?
Mr. Panangala. You are right.
Mr. Hall. You are recognized for 5 minutes, sir.
STATEMENT OF SIDATH VIRANGA PANANGALA
Mr. Panangala. Thank you, Chairman Hall, Ranking Member
Lamborn, and Members of the Subcommittee. My name is Sidath
Panangala from the Congressional Research Service. I am
accompanied today by Christine Scott and Douglas Weimer, both
from CRS. We are honored to appear before the Subcommittee
today.
As requested by the Subcommittee, my testimony will
highlight major legislative milestones in the establishment of
presumptions of service connection for veterans benefits. A
copy of my full statement is submitted for the record.
CRS takes no position on any legislation that is under
discussion today. In general, a veteran is entitled to
compensation for disabilities incurred or activated during
Active military, naval, or air service.
Currently, there are five ways to establish a disability is
service-connected. First, there is direct evidence that the
injury or disease was incurred while in military service.
Second, in the case of a preexisting injury or disease,
there is evidence that it was aggravated while in service.
Third, through proximity to a service-connected condition;
by example, veteran developing cardiovascular disease due to a
service-connected amputation of the lower leg.
Fourth, the injury or disease is caused by VA medical care
or vocational rehabilitation.
And finally, a service connection may be established by
creating a presumption, either through statutory or
administrative action, that a particular disease or diseases
were incurred or aggravated by military service. Such
presumptions, which are the focus of this testimony, relieve
the veteran of having to prove that a particular disease was
caused by exposure to a physical, chemical or biologic agent
during his service.
The legislative history of veterans' disease presumptions
dates back to 1921, when Congress established a presumption of
service connection with an amendment to the War Risk Insurance
Act. This established presumption of service connection for
tuberculosis and neuropsychiatric diseases, which today is
known as psychosis, occurring within 2 years of separation from
Active military service.
In the following years, additions to the presumption lists
were made by regulation, Executive Order, and legislation. The
next major legislative change occurred with the enactment of
Public Law 91-376 in 1970. This law established a presumption
of service connection for seven categories of diseases and
conditions for any veteran held as a prisoner of war.
It should be noted that up until this time, all statutory
presumptions had a presumptive period in which a disease or
illness needed to have manifested itself. Typically this was
about 1 year after separation from Active service.
In the past 20 years, Congress has on three separate
occasions created presumptive programs for three distinct
groups of veterans, so-called atomic veterans, who were exposed
to radiation from atomic above-ground nuclear tests and atomic
bombs detonated in Japan; Vietnam veterans; and Gulf war
veterans.
In 1988, the Radiation-Exposed Veterans' Compensation Act
established a presumption of service connection for 13
specified types of cancers. That list was subsequently expanded
first by legislation, later through VA administrative action,
to 21 cancers.
In 1991, the Agent Orange Act established for Vietnam
veterans a presumption of service connection for diseases
associated with exposure to Agent Orange and other herbicides.
For the first time, this act required the VA to contract with
the Institute of Medicine to conduct every 2 years a scientific
review of the evidence linking certain medical conditions to
herbicide exposure. The VA was instructed to use IOM's findings
and other evidence to issue regulations establishing a
presumption for any disease for which there is scientific
evidence of an association with the herbicide exposure.
In 1998, Congress enacted the Persian Gulf War Veterans Act
and the Veterans Programs Enhancement Act. Similar to the Agent
Orange presumptive program, these laws mandated regular and
thorough reviews of the scientific and medical literature
relevant to the health of Gulf War veterans by IOM.
Next, as requested, I would briefly mention the IOM study
on presumptive disability decisionmaking. In 2006, the Veterans
Disability Benefits Commission requested IOM to provide a
framework on how future presumptions should be made based on
scientific principles. In 2007, IOM recommended the
establishment of a permanent advisory Committee and a
scientific review board. According to IOM, and I quote, the
advisory Committee would consider and give priority to the
exposures and health conditions proposed for possible
presumptive evaluation, while the science review board, an
independent body, would evaluate the strength of the evidence
based on causation that links a health condition to military
exposure, end of quote.
Next, the independent science review board's report and
recommendations would go to the VA for its consideration and
implementation.
In conclusion, since 1921, Congress has established
numerous presumptions of service connection for a variety of
health conditions affecting veterans. Establishing these
presumptions, Congress and others have sought to balance the
dual obligations of the VA to provide care for veterans who
have been harmed by their service, and to do so in a manner
that is equitable, scientifically sound, and accountable.
This concludes my statement. I will be happy to answer any
questions you may have. Thank you.
[The prepared statement of Mr. Panangala appears on p. 70.]
Mr. Hall. Thank you so much, Sidath. I appreciate your
testimony. I just want to note that we are entering the
attachments of the IOM studies referred to into the record,
graphs and figures and so on that you were referring to, as
part of the official record of this proceeding.
Without objection, so ordered.
[The attachments of the IOM study appear on p. 118.]
Mr. Hall. Christine Scott, you are now recognized for 5
minutes.
Ms. Scott. Mr. Panangala presented testimony. We are here
to help answer questions.
Mr. Hall. Would you like to say anything?
No. That is fine.
Mr. Weimer.
Mr. Weimer. Thank you, Mr. Chairman. My comments were
delivered by Mr. Panangala.
Mr. Hall. Thank you so much. They are in the record, and I
appreciate you being here and submitting them.
So we will now have, hopefully, a brief round of questions.
Ms. Salerno, thank you again for joining us. The IOM's
report, ``Improving the Presumptive Disability Decision-Making
Process for Veterans,'' outlines a new paradigm for determining
presumptions of disability compensation.
Could you please elaborate on this new system, highlighting
the differences with the current method? And please talk about
the proposed science review board process.
Ms. Salerno. Yes.
The idea was to have a process which was clear and
transparent. There seems to be--when charges come to the IOM or
various committees to evaluate information, the charges vary as
to how one should weigh criteria. With this new framework,
there would be, first, an advisory panel, advisory to the VA,
which would take into consideration all the views of
stakeholders and evaluate the priorities for which conditions
should be under consideration for presumption.
Then the task would go to a scientific review board, which
would evaluate, based on the best available scientific
knowledge at the time, the process and make recommendations to
VA.
The VA would then take that information to the Secretary of
Veterans Affairs, and based on clear and transparent criteria
for what would be the threshold for presumption, would make a
decision and put it into policy. So all along the way the
process would be different.
Mr. Hall. Thank you.
Congressman Thompson introduced his joint letter, dated
February 15, 2008, addressed to Dr. Rick Erdtmann of the IOM,
detailing their issues with the IOM study.
Were you aware of this letter, and can you give me an
update on where the IOM stands on review and/or reopening of
the 2007 study on the long-term health effects of participation
in Project SHAD?
Ms. Salerno. Yes, sir, I would be happy to.
We did receive the letter and we looked at the five issues
that were raised in the Congressman's letter. And we take their
concerns very seriously, and we think they raise some very
critical points for us to consider.
So we have been open to thinking about how to discuss these
issues that were raised, and we have decided that we would
provide additional analyses of the data based on their concerns
and questions. And we have done that.
Now, these findings from the reevaluation of the data are
being sent to an independent panel of national experts who have
not been involved previously with any of the Project SHAD
studies for an independent peer review. And then we will
provide this information to the Congressman, and we hope it
will address all of their concerns.
Mr. Hall. With regard to point three of the letter, can you
tell me what the potential impact on the results of the study
was of omitting the health records of deceased Project SHAD
participants, and is it possible that it skewed any of the
results?
Ms. Salerno. I have to see what point three is.
Yes. The deceased for whom we didn't have any other
information other than that they had died were, in the initial
evaluation, not included except to note that they had passed
away. It was a very small number relative to the over 5,500
veterans who were exposed and included in the study. It was
literally a handful.
Attempts were made to obtain additional information on
them, and we would be happy to consider additional information
on these few veterans if and when they become available.
Mr. Hall. Thank you. I think it is an interesting and valid
question that Mr. Thompson and Mr. Rehberg were asking: If the
cause-of-death information is available for those individuals,
whether it is possible to measure what impact that information
would have had on the outcome of the study.
So if you could follow up on that and let us know.
Ms. Salerno. Be happy to.
Mr. Hall. I do not know in terms of relative size, what
percentage you are talking about, but nonetheless I think it
would be good to get an answer to that, if possible.
I wanted to also ask briefly, Mr. Panangala, Parkinson's
disease is already listed as a chronic condition under title 38
of the U.S. Code, section 1101.
In your opinion, is a separate presumption needed?
Mr. Panangala. I believe the disease is in the title, but I
think there is a time limit that is in the regulations and
statute that you had to be diagnosed with. I believe the
legislation needs to remove that time limit. That is my
understanding.
I can't say that that should be done or not, but that is my
understanding of it, so I cannot comment beyond that
explanation.
Mr. Hall. If the 1-year presumptive window did not close
for these conditions, would VA already be service-connecting
those veterans affected by ALS even after a 1-year lapse after
separation?
Mr. Panangala. Can you repeat that question?
Mr. Hall. Yes. If the 1-year presumptive window did not
close, if it were not a factor in the VA's deliberations, would
VA be service-connecting those veterans afflicted by ALS even
after a year, post separation?
Mr. Panangala. That means you are asking whether VA would
go ahead and establish the presumption after----
Mr. Hall. Does ALS manifest more than a year after
separation or does the veteran sometimes take that long or
longer to recognize the symptoms and come to VA?
Mr. Panangala [continuing]. I cannot comment on that
because I am not an expert. But we will be happy to get back to
the Subcommittee after taking a look at that issue.
[Mr. Panangala provided followup information in an October
21, 2008, Memo, which appears on p. 70.]
Mr. Hall. Thank you very much. My time has expired.
I will now recognize Ranking Member Lamborn.
Mr. Lamborn. I have some, but I am going to save them for
another panel.
Mr. Hall. In that case, Mr. Bilirakis.
Mr. Bilirakis. I am fine, thank you. Thank you, Mr.
Chairman.
Mr. Hall. Mr. Bilirakis yields. So, you are in luck. Thank
you so much for your testimony. It has been very helpful. You
are now excused.
Our second panel is excused. Have a lovely afternoon. Thank
you for being here with us.
Our third panel is called to the table. Les Jackson,
Executive Director of American Ex-Prisoners of War; Steve
Smithson, Deputy Director of Veterans Affairs and
Rehabilitation Commission of the American Legion; John Rowan,
National President, Vietnam Veterans of America (VVA);
Lieutenant Commander Jack Alderson, USN, Retired, Ferndale,
California; Jeff Faull, McEwersville, Pennsylvania, a disabled
veteran, on behalf of the ALS Association; David Woods,
Director of Veterans Affairs of Scott County, Iowa.
We will take a moment while people get into their places.
As usual, without objection, we will enter the written
testimony into the record--without objection, so ordered--so
other witnesses may feel free to shorten or lengthen their
testimony as you like.
Whichever it is, there is a five-minute clock. You will see
the lights go from green to red, as usual.
Thank you for joining us. Thank you for your patience with
our having to run across the street and vote.
Mr. Hall. We will start by recognizing Les Jackson,
Executive Director from the American Ex-Prisoners of War.
Mr. Jackson.
STATEMENTS OF LES JACKSON, EXECUTIVE DIRECTOR, AMERICAN EX-
PRISONERS OF WAR; ACCOMPANIED BY REV. JACK MATHISON; STEVE
SMITHSON, DEPUTY DIRECTOR, VETERANS AFFAIRS AND REHABILITATION
COMMISSION, AMERICAN LEGION; JOHN ROWAN, NATIONAL PRESIDENT,
VIETNAM VETERANS OF AMERICA; LIEUTENANT COMMANDER JACK B.
ALDERSON, USNR (RET.), FERNDALE, CA; JEFF FAULL, MCEWERSILLE,
PA (DISABLED VETERAN), ON BEHALF OF THE ALS ASSOCIATION; DAVID
WOODS, DIRECTOR, VETERANS AFFAIRS OF SCOTT COUNTY, IOWA
STATEMENT OF LES JACKSON
Mr. Jackson. Mr. Chairman, I recently returned from the
Blind Rehabilitation Center, operated by the Veterans
Administration in Connecticut. I am unable to read my
testimony, and I have asked another former prisoner of war,
Reverend Jack Mathison, if he would read the statement that the
American Ex-Prisoners of Wars has prepared for this statement.
Mr. Mathison. Chairman Hall, distinguished Members of the
Subcommittee on Disability Assistance and Memorial Affairs, and
guests. Thank you for inviting us to participate in your
legislative hearing on several bills now pending in the House
Committee on Veterans' Affairs. We will confine our remarks to
House Committee bill H.R. 1197, the ``Improved Veterans
Benefits for Former Prisoners of War.''
Ninety-nine percent of former prisoners of war are from
World War II and Korea and are now living in their sunset
years. We are grateful that Congress has, through the years,
provided benefits for former prisoners of war where it has been
determined that the causal effect of an injury or illness is
from the captive experience.
For more than 50 years, the National Academy of Sciences
has been conducting scientific research to identify medical
conditions that, beyond any doubt, are the direct consequences
of the brutal conditions of captivity. There are two medical
conditions cited that still deserve presumptive status. These
are osteoporosis and diabetes. Osteoporosis is bone loss
attributed to starvation during captivity. Similarly, diabetes
is the result of prolonged stress and permanent damage to the
body's basic defense system as a result of months and years of
grossly inadequate diet as a prisoner of war.
These two proposed presumptives have, again, been
introduced by Representative Gus Bilirakis, Republican of
Florida. We are deeply thankful to him and strongly urge your
Subcommittee's support by codifying these two conditions into
law without further delay.
Also very important to former prisoners of war and their
survivors is House bill 156 to amend 38 U.S. Code to provide
for the payment of Dependents Indemnity Compensation (DIC) to
survivors of former POWs who died before September 30, 1999,
with the same eligibility as applied to payment of DIC to
survivors of former POWs who die after that date. This will be
of great financial aid to the surviving spouses of POWs.
We thank you for giving us this opportunity.
[The prepared statement of Mr. Jackson appears on p. 74.]
Mr. Hall. Thank you, sir, for your testimony and for your
service. Mr. Jackson, thank you for your service to our
country.
We now recognize Mr. Smithson for 5 minutes.
STATEMENT OF STEVE SMITHSON
Mr. Smithson. Good afternoon, Mr. Chairman and Members of
the Subcommittee. I appreciate the opportunity to appear before
you this afternoon to offer the American Legion's views on the
various bills being considered by the Subcommittee today.
The American Legion is generally pleased with the intent of
these bills. Due to the time constraints this afternoon, I am
going to limit my oral remarks to just a few of the bills being
considered.
H.R. 5985, the ``Compensation for Combat Veterans Act,''
the purpose of this bill is to amend title 38, United States
Code, to clarify the service treatable as service-engaged in
combat with the enemy for utilization of nonofficial evidence
for proof of service connection in combat-related disease or
injury.
A bill with similar intent, H.R. 5892, was recently passed
by the Committee. Both title I of H.R. 5892 and this bill seek
to define ``engaged in combat with the enemy'' under title 38,
United States Code, section 1154(b) in a manner that is
consistent with the realities of combat in today's world. The
American Legion supports the intent of these bills.
Given the evolving nature of modern warfare as reflected in
the enemy's unconventional tactics in Iraq and Afghanistan, the
American Legion is of the opinion that it not only makes sense
to clarify the definition of ``engaged in combat with the
enemy'' under 38 U.S.C. 1154(b) in order to adapt to the new
realities of modern war. It is essential that we do so not just
for those serving now, but for those who have served in the
past and those who will serve in the future.
H.R. 1198, the ``Prisoner of War Benefits Act of 2007,''
the American Legion supports this legislation. It represents a
solid step toward ensuring that former POWs receive the
compensation and medical care to which they are clearly
entitled. However, in addition to those diseases that will be
presumed service-connected, the American Legion recommends that
the list also include chronic pulmonary disease where there is
a history of forced labor in mines during captivity, and
generalized osteoarthritis as differentiated from the currently
listed disability of post traumatic osteoarthritis.
H.R. 5155, the ``Combat Veterans Debt Elimination Act of
2008,'' although we agree with the intent of this bill, the
legislation contains limitations and restrictions we do not
support. The American Legion supports prohibiting the
collection of debts in the case of any veteran who dies as a
result of service-connected disability, not just those who die
of a service-connected disability incurred or aggravated while
serving in a theater of combat operations or in combat against
a hostile force during a period of hostility.
A veteran's death due to a service-connected disability not
related to combat is no less tragic for the veteran's family
than a death due to a combat-related service-connected
condition, and we see no justification in making such a
distinction.
This bill also leaves it up to the discretion of the
Secretary of Veterans Affairs to determine if termination of
collection of the debt is in the best interest of the United
States. It does not set forth any standards or criteria in
determining whether or not termination of collection is in the
country's best interest.
Unfortunately, such vagueness will likely result in a
restrictive interpretation, which will, in turn, limit the
beneficial impact that was obviously intended. The American
Legion has concerns over the exclusion from the prohibition of
collection of debts involving housing and small business
benefit programs.
H.R. 5454: This bill, if enacted, would establish
presumptive service connection of ALS for veterans who develop
the disease to the degree of 10 percent of more disabling
anytime after military service. The American Legion fully
supports this legislation. The very nature of ALS warrants an
indefinite presumptive period, as delayed diagnosis and even
misdiagnosis is common with this terrible disease.
The timeliness and appropriateness of this bill is further
supported by research and other evidence in the last several
years, including a November, 2006, IOM report that has
indicated that those who served in the military are at greater
risk of developing ALS than those who never served in the
military.
The last bill I will discuss this afternoon, H.R. 5954: The
American Legion fully supports this bill, as it will put in
place the process for establishing presumption of service
connection for diseases that have been scientifically
associated with exposure to the various agents and chemicals
used in Project 112.
This concludes my testimony, Mr. Chairman. I would be happy
to answer any questions you or Members of the Subcommittee may
have.
[The prepared statement of Mr. Smithson appears on p. 74.]
Mr. Hall. Thank you very much, Mr. Smithson. We will get
back to you with questions shortly.
Next, we will recognize Mr. John Rowan, National President
of the Vietnam Veterans of America.
STATEMENT OF JOHN ROWAN
Mr. Rowan. Good afternoon, Mr. Chairman, Chairman Hall, Mr.
Lamborn, Mr. Bilirakis. You folks have been busy, to say the
least.
We have a formal statement that I would submit for the
record which comments on all of the legislation in more depth.
But there are a couple we just wanted to touch base on. You
will also hear more from our colleagues at this table about
H.R. 5944, the SHAD and 112 Project legislation.
VVA was very much out front on this very early on, and we
worked Mr. Alderson and Mr. LaChapelle and others and had the
Subcommittee of the VVA to go after this whole SHAD-Project 112
thing. We applaud Representatives Thompson and Rehberg for
introducing and fighting for this legislation.
If we have a caveat on any of this piece of legislation, it
is the issue of the date 1963. We believe that we should go
much sooner or earlier--or later, depending how you look it at.
Prior to 1963, there were all kinds of other programs going on,
and the DoD is finally starting to dig into this and letting us
know all of these different programs that exposed people to all
kinds of different things in addition to the SHAD and 112, the
incidents. So we think that those veterans also are entitled to
compensation for anything that may occur from their being
exposed to all kinds of interesting chemical, biological, and
other kind of agents.
We also support H.R. 3008, about giving more help for rural
veterans. One of our concerns, however, is, we would like to
see the veterans service organizations, including the
possibility of receiving those grants to help assist providing
claims compensation and other kinds of programs out in the
field. Many of our organizations have service officers who are
out there, as well as the State and county folks, and many of
them are out in the rural areas, and we would like to see,
possibly including the VSOs, possibly be getting some of that
grant money to help us do that.
The more service officers, the better, in my opinion. We
never have enough of them out there at all. Far too many people
lose their opportunity to get fully compensated for their
service.
H.R. 3070, an interesting bill. We are interested in how
you came up with $234 as a dollar figure. We think that was
kind of interesting, and kind of low. We are really concerned
about a lot of these compensation issues and a lot of the
dollar amounts, quite honestly.
DIC is another one, frankly, that needs to be looked at in
where we go. Of course, the whole DIC-Survivor Benefit Plan
(SBP) breakdown, people lose money because they are getting a
pension benefit, which makes no sense.
Basically, we primarily support all of these bills. We have
nuances on each one of them, or most of them anyway.
H.R. 5448, we are glad to see the elimination of this
onerous requirement to prove stressors. For those of us who
have been out in the field and had to file claims with
veterans, I can tell you, having done that for a couple of
years myself after I had retired back in 2002, it was very
disheartening to have to sit in front and talk to a veteran who
had gone through a year in Vietnam, did all kinds of strange
and horrible things, but couldn't get him any compensation for
his PTSD because he didn't have the right badge and the right
award.
Today, of course, we now know the most dangerous job in
Iraq probably is being a truck driver. There were many truck
drivers back in the days of Vietnam, as well, and people like
that who had to go out in the field and were engaged in combat,
were fired upon, had all kinds of things; but because they
didn't get the right designation or didn't get the right badge
because they didn't have the right military occupational skills
MOS or occupational thing, that they didn't get considered the
right stressor. Then we have to go through a whole song and
dance and try to prove that stressor.
So we applaud the Subcommittee on its activity, its
actions, its trying to catch up on things. I agree with the
Chairman, Mr. Filner, a lot of the bills are long overdue
justice.
Thank you.
[The prepared statement of Mr. Rowan appears on p. 78.]
Mr. Hall. Thank you, Mr. Rowan.
Lieutenant Commander Alderson, you are now recognized for 5
minutes.
STATEMENT OF LIEUTENANT COMMANDER
JACK B. ALDERSON, USNR (RET.)
Commander Alderson. Thank you, Mr. Chairman, Ranking Member
Lamborn, and distinguished Members of the Subcommittee. My name
is Jack Alderson, I live in Ferndale, California. I am a
retired U.S. Navy Reserve Lieutenant Commander.
While on active duty, I was ordered to Project SHAD
technical staff as officer in charge of the five Army Light
Tugs. I was part of the technical staff for approximately 3
years, and was involved in tests at Shady Grove, Big Tom, Half
Note, and Folded Arrow; these tested biological weapons. The
only ones that DoD has admitted to so far--and there were
many--were Q fever and tularemia. Simulants used in the same
conjunction were Bacillus Globigii, Serratia marcescens, and E.
coli, all of which are known as hazardous to human health.
We decontaminated the vessels using agents such as HTH,
(chlorine), ethylene oxide, formalin, and betapropiolactone,
all of which are highly carcinogenic.
Each Army tug was manned by a Navy crew captained by a U.S.
Navy lieutenant. The crews were hand-picked and had a security
clearance of final secret. The mission of the tech staff,
consisting of laboratory, ordnance personal and crews of the
tugs, was to test at sea chemical and biological weapons. While
in SHAD, I was involved in the training, planning and execution
of tug operations.
The written testimony describes test operations, including
cleanup utilizing the named highly carcinogenic chemicals.
Here, I stress, we know that the weapons and simulants
penetrated the tugs. SHAD training used the simulants and
chemical decontamination agents often in training; in other
words, we were exposed to health hazards almost continuously,
and what we used as training was what the other vessels that
were involved in 112 and so forth considered as being in a
test.
When departing SHAD, we were forcefully debriefed to say
nothing about our time in SHAD. With that secrecy, it was not
until the early nineties that I became cognizant of the health
problems of SHAD personnel. When health problems occurred and
the SHAD personnel went to the VA, they were shown the door.
Many went to their veteran service officers but were admonished
that the U.S. Government would not treat service personnel that
way.
Let me give you three examples. Lieutenant Ken Frazier, who
happens to also be Congressman Thompson's constituent,
skippered the 2085. He received the letter from VA and twice
traveled to the VA facility in Oregon with it in hand. He was
turned away both times, as they didn't know anything about
SHAD. Ken died of cancer of the esophagus and lungs in 2004.
Ken's widow is worried about her health and her daughter's
health.
Larry Pilkinton was a hospital corpsman with 15 years
commendable service. He had a final secret and interim top
secret clearance. He was bit by serin while loading bomblets on
the Big Island. He was transferred from Tripler to Oak Knoll
Naval Hospital, where he was discharged as having prior mental
problems before enlisting in the U.S. service. Larry received
no help from the VA, and died May 29, 2007. His widow has no
benefits.
Homer Tack was a sailor in Copperhead on board the USS
Power. He has very serious pulmonary problems. Recently, his VA
tests and private tests have shown the seriousness of the
problem. It has been over 200 days since the tests were given,
and still no decision by VA.
We were ordered to SHAD to test chemical and biological
weapons and then clean up with after the test. The cleanup was
done with harsh carcinogenic chemicals.
DoD, for security reasons, has not disclosed all weapons
tested in SHAD. In fact, in the Shady Grove fact sheet they do
not even list the decontamination agents that I have listed
here. I have just named them and can attest to what they were
because I was involved in the utilization and the testing.
Without full disclosure of the biological and chemicals use
in SHAD operations, the VA cannot equate problems of health and
SHAD exposure. The veterans seriously need H.R. 5954 to assist
in helping with their problems acquired during their very
unique service to our Nation.
Thank you.
[The prepared statement of Lieutenant Commander Alderson
appears on p. 83.]
Mr. Hall. Lieutenant Commander, thank you so much for your
testimony and your service to our country and your service to
your fellow veterans, especially those who were exposed during
these tests.
Next, we will recognize Jeff Faull, disabled veteran, on
behalf of The ALS Association.
STATEMENT OF JEFF FAULL
Mr. Faull. Good afternoon, Chairman Hall, Ranking Member
Lamborn, Members of the Subcommittee.
As you said, my name is Jeff Faull. I am from a small town
in northeastern Pennsylvania, McEwensville. I appreciate the
opportunity to speak with you this morning on behalf of the ALS
Association and the veterans living with ALS. I hope that by
sharing my experience with you today, you will gain a better
understanding of how this disease impacts vets across country,
and why H.R. 5454 is so urgently needed.
Before I begin, I would like to thank Congressman Henry
Brown and Congressman David Price for their leadership in
introducing this vital legislation. Veterans with ALS across
the country are truly grateful for their efforts.
I joined the Navy in 1992 at the age of 24, and served two
tours of duty as a nuclear electronics technician, including 4
years aboard the USS Theodore Roosevelt. During that time I
participated in Operation Southern Watch Deliberate Force,
Allied Force, and Noble Anvil. Prior to my assignment aboard
the Roosevelt, I was stationed at Knolls Power Laboratory
Kesselring Site in West Milton, New York, located not too far
from your district, Mr. Chairman.
I left the Navy in 2000 to spend more time with my wife,
Tammy, and our daughters Tiffany and Breanna. Like many other
veterans, I never thought that my service in the military would
cause health problems years after I left the service. I never
thought that I would have to fight to obtain benefits from the
VA. I never thought I would be sitting here today before you
with a diagnosis of ALS, or Lou Gehrig's disease.
For me and thousands of veterans across the country, the
reality is that years or even decades after serving the country
we are being diagnosed with ALS, and we are fighting for
benefits at the same time we are fighting this disease.
I was diagnosed with ALS just over a year ago in February,
2007, at the age of 38, about 20 years younger than the typical
person with ALS. At the time, I had no idea what ALS was.
Amyotrophic lateral sclerosis meant nothing to me, as I am sure
it means nothing to thousands of others when they are first
diagnosed, but I can assure you it is a whole different story
when the doctor looks at you and says, ``Unfortunately, you
don't have cancer.'' That is when you begin to understand how
serious ALS really is.
ALS is a rapidly progressive and invariably fatal
neurological disease that attacks the neurons responsible for
controlling voluntary muscles. To put it simply, this disease
will rob me of my ability to walk, talk, move, and breathe.
There is little I can do to slow the progression, as there is
no effective treatment and no cure. The disease is usually
fatal in about 2 to 5 years. In fact, of the more than 2,000
veterans who are enrolled in the VA ALS registry over the past
4 years, less than 900 are still with us today.
I first noticed the symptoms of ALS as early as 1999 when I
experienced cramps and twitching in my left hand and arm. As
time passed, I began to develop weakness, then loss of muscle
mass, which eventually led to my diagnosis last year. Since the
diagnosis, the weakness and atrophy have spread and gotten
worse. Both hands and arms are now weak, walking is becoming
more difficult; and as you can hear, my speech is beginning to
be affected. I keep a pair of slip-joint pliers in the kitchen
to open things. My wife, Tammy, who is with me here today,
normally makes sure that things like cereal boxes are open for
me. Otherwise, I have to ask for help from my daughters.
Although they have no problems helping their old man, it is
not how I pictured spending my time with them. I can't make the
walk to see Breanna play soccer. I don't have the arm strength
to shoot basketball with Tiffany. I will more than likely be in
a wheelchair when it comes time to teach them to drive.
These are the treasures this disease steals from thousands
of veterans every year before it takes our lives. In fact, I
understand that recent research, which has not yet been
published, suggested ALS is occurring at even greater rates in
those serving in the conflict in Iraq.
Past studies have shown, a Harvard study, that all
veterans, regardless of time and place of service, are almost
twice as likely to develop ALS. What is alarming about this
information and the evidence from prior research is that we are
seeing ALS at an age when we generally do not see the disease.
I was 38 when I was diagnosed. Most people diagnosed are in
their fifties, sixties, or seventies.
What will we see 10, 15, 20 years in the future as the men
and women serving today leave the military? It is clear that
regardless of when and where someone served the military, they
are at a greater risk of dying from this disease than if they
had not served in the military.
Despite the evidence showing that all U.S. military
veterans are at greater risk of ALS, the VA has not created a
presumption of service connection for all veterans with ALS.
Thousands of veterans continue to be left behind, and hundreds
of thousands serving in the military today, including in Iraq
and Afghanistan, continue to be at a greater risk of dying from
this disease.
The VA will respond that any veteran with ALS can be
service-connected on the basis of specific evidence supporting
their case. As someone who has been denied service connection
and knows countless others who have, as well, I can tell you
that this response demonstrates a lack of understanding of this
disease.
The reality is that the majority of veterans with ALS who
do not fall under the current limited presumptions are forced
to fight for their benefits, and we are usually denied. I have
been attempting to establish service connection for over a year
now and have submitted reams of scientific and medical
evidence, including letters supporting my claim from my
neurologist. Yet, that evidence has fallen on deaf ears.
Part of the problem we face is the nature of the disease
itself. ALS is an insidious disease. First, the symptoms, such
as the ones I experienced while on active duty, are so benign,
they often go unreported. How many of us in this room have
experienced muscle cramps and twitching and thought nothing of
it? They are symptoms of ALS. Yet, they are not documented in
our service medical records simply because we did not think
them a big deal at the time. How many of us on active duty
actually thought we would succumb to muscle twitching?
In addition, it can be years from discharge until the onset
of symptoms or between onset and diagnosis, while after the 1
year presumptive period has ended and there is no simple way to
diagnosis ALS, no single test you can take that says you have
ALS. Rather, there is a diagnosis of exclusion, ruling out
every other possible diagnosis.
The bottom line is that if you are not diagnosed while on
active duty and did not serve in the Gulf, the VA likely will
not consider ALS to be service-connected, despite the studies
and the fact that the VA and DoD both recognize ALS is a high
priority of research. In addition to the studies that I have
referenced, there are multiple peer-reviewed studies linking
ALS to many of the things our military personnel are exposed to
on a regular basis. These include ionizing and nonionizing
radiation, fuels, solvents, lead, vapors, and vaccinations.
My question as a veteran with ALS trying to establish a
connection is, what additional proof must I provide? How many
more studies are needed? How many veterans have to develop ALS
and die from it before the VA takes action?
I can only hope this quick glance into my life with ALS and
attempts for service connection grant you the understanding to
see the importance of establishing a presumption of service
connection for all veterans with ALS, which is exactly what
H.R. 5454 will do.
We have to fight for our lives. We should not also have to
fight for the benefits the evidence shows we deserve.
Abraham Lincoln's statement, which was later adopted by the
VA as their motto states, ``To care for him who shall have
borne the battle and for his widow, and his orphan.'' I, and
the other veterans with this horrible disease, appreciate your
time and effort to ensure that that statement is more than
words. I urge you to support H.R. 5454 and help ensure that no
veteran with ALS is ever left behind.
Thank you again for your time and the opportunity to speak
with you.
[The prepared statement of Mr. Faull appears on p. 85.]
Mr. Hall. Thank you very much, Mr. Faull. Thank you for
your service to our country. Thank you to your family for your
sacrifice as well.
How many more studies are needed?
Mr. Faull. That question I have now the evidence shows----
Mr. Hall. It's a rhetorical question, you have enough
studies.
I am thinking about a Bob Dylan line about how many years
must a mountain exist before it is washed to the sea. But we
won't go into that at this time.
Our next witness is David Woods, the Director of the
Veterans Affairs for Scott County, Iowa.
Mr. Woods, you are recognized for 5 minutes.
STATEMENT OF DAVID WOODS
Mr. Woods. Mr. Chairman, thank you for allowing me to be
here today to discuss Congressman Braley's bill on the
compensation for combat veterans.
I am the Director of Veterans Affairs for Scott County in
Iowa. I am also a Vietnam veteran. I have been awarded the
combat infantry badge (CIB), the Purple Heart and the Silver
Star. I was wounded June 12, 1970. Happy anniversary. So I have
a feeling for just what our veterans are going through today.
My job as a veterans service officer in Scott County is to
listen to these veterans, get them their medical help and the
compensation that is due them. I also help them through the
Veterans Administration, the tangle of paperwork that they have
to go through, and make sure that they understand what they are
entitled to for their benefits.
Having witnessed, through my combat experiences, I
understand and am able to talk to these veterans, and they will
sit there and tell me things that they have never told their
families, their wives, or anyone else. Because I have been in
combat, they can talk to me about it.
I have had veterans come into my office, and after asking
them where were you at, when were you in a certain area, what
unit were you with, or who was wounded or killed by you, they
look at you and stare off into space because they have no idea.
They forgot that stuff.
Now, how about the Vietnam veterans who have been trying to
forget about his time 40 years ago? The cases of PTSD have
risen because of the Iraq-Afghanistan war. After 40 years of
him trying to forget where he was at or what he was doing, and
then now asking him to try to remember where he was at on a
certain date or where he was at, what people were injured by
him, it is just impossible. They look at you and they have no
idea because they have been trying to forget this horrible
memory for years.
For our Iraq-Afghanistan veterans, there are times when
that military police or engineer or even a cook might be pulled
from his job and sent on convoy duty. Many times when that
change happens, it is not documented in their files. Then, when
he is sent on that job, he might not be working with his own
unit or his combat buddies. Then, if they receive incoming
rounds, it is not documented because it is an everyday
occurrence for a lot of them over there.
I have had National Guard veterans come into my office and
apply for compensation, because they have come in and we have
applied through the VA, they have been turned down by the VA
mainly because his part of the unit has come back to the
country; another part of his National Guard unit might still be
overseas, and those records are still over there. So then that
veteran has to go out there and, as mentioned before, find a
buddy from his combat unit that witnessed something and write
it up. Then we have to put it through the VA to have them
accept it. This is not right.
I have had an Iraqi veteran with TBI, traumatic brain
injury, file for compensation, but because he had no CIB,
Purple Heart, or other combat medal, he was turned down by the
VA for his compensation. His DD 214, his discharge papers show
that he was in Iraq, listing the date and unit, but nothing
else. When we filed the compensation claim, that veteran was
treated at the Iowa City VAMC medical center. He was found to
have TBI and he was awarded his compensation.
If you were to ask a combat medic what his job was, he
would tell you that he was to keep that injured soldier alive
and let the people in the background do the paperwork. If you
were to look at my medical report, it says that I was injured
in the left arm and the neck. Neither happened to me when I was
hit. That medic did not carry a file for every soldier that is
out in the field; that is not his job. So there is no way of
knowing just what a soldier went through or where he was hit,
or whatever, a lot of times until later on. It is still not
possible today to keep these records.
Case in point: I had a World War II veteran come into my
office wanting to get his Purple Heart, which he had never
received. His records were burned up in the big fire in St.
Louis. He just kind of thought nothing of it, but his family
wanted the Purple Heart.
He came into my office. We filed the paperwork with the VA.
They said, nope, can't find anything at all on him. So I did
some phone calls, found out that I could write a letter to the
Unit Records section down in St. Louis. We did that.
The gentleman got his paperwork from the Unit Records
section. He brought it into my office. I read it, and he said,
What do you think, Woody? I said, You're dead in the water,
because it had him down in the medical records for an illness,
not being wounded over in Germany. As far as the buddy
statement, his tank crew members were all killed when he was
hit and injured. So his Purple Heart, I did not get.
I have had a Vietnam veteran come into my office to apply
for compensation for Agent Orange type 2 diabetes. That veteran
was a deepwater Navy veteran. And when we applied for the
compensation, of course, the VA came back with the Haas v.
Nickelsen case, saying he was never in Vietnam. I asked the
veteran if he had contact with any of his fellow Navy
personnel, and the next day he came into my office with two e-
mail addresses.
I sent off an e-mail to the gentleman. I got an answer back
the very next day. The gentleman was the third ranking officer
on his ship. His ship was permanently stationed right off of
the tip of South Vietnam. The third officer sent me the letter
saying it was common knowledge that replacement sailors would
fly into Vietnam, take 2 days to truck down to the southern
part of Vietnam, be boated out to the ship, and then, really to
add insult to the VA and the Navy records, the same gentleman
told me that every 2 to 3 months they would go onto an island
off of South Vietnam and have volley ball and R&R.
So definitely this gentleman was in country and definitely
he should have been connected for his type 2 diabetes. We are
still waiting from the VA on that case.
These are just a fraction of the compensation claims that
we are fighting with the VA.
These last wars are not like World War I and World War II
where you knew who your enemy was or where the frontlines were.
Now we have no lines or enemies in a certain uniform. There are
not many safe areas for our veterans of today, who can actually
relax. It doesn't take much incoming to put stress and pressure
on our veterans, and that is what we are finding out today.
Thank you for letting me speak to you today.
[The prepared statement of Mr. Woods appears on p. 87.]
Mr. Hall. Thank you, Mr. Woods.
Without objection, I will ask Mr. Bilirakis if he would
like to start off our questioning at this time.
Mr. Bilirakis. Thank you, Mr. Chairman. I appreciate it
very much. Thank you, gentlemen, for testifying today, and
thank you for your service.
Mr. Jackson, do you have an estimate on how many former
prisoners of war are living today?
Mr. Jackson. It seems to me that it is 2,000.
No, 20,000
Mr. Bilirakis. About 20,000. What is the average age, would
you say?
Mr. Jackson. I have been the average age for a long time,
of our group, which is, today I am 87 years old.
Mr. Bilirakis. Eighty-seven.
How many would you estimate would benefit from this bill,
H.R. 1197?
Mr. Jackson. I honestly don't know. But I know that they
are out there.
Mr. Bilirakis. Okay. Thank you very much.
Does anyone else want to answer those questions? Okay.
Thank you very much. We will do the research. I appreciate it,
Mr. Jackson. Thank you.
No further questions.
Mr. Hall. Thank you, Mr. Bilirakis. I would like to ask Mr.
Jackson, I know that adding osteoporosis and type 2 diabetes
have been priority presumptive conditions that your
organization has wanted to add to the list, and that you are
awaiting passage of S. 1315, which contains a provision to add
osteoporosis for those afflicted with PTSD to this list.
Are you aware of any other conditions that you think
deserve presumptive status for former POWs?
Mr. Jackson. No, sir, I am not.
Mr. Hall. The VA's testimony states that it is unaware of
studies that associate type 2 diabetes or osteoporosis with POW
internment. What evidence is your organization aware of that
they are not, which would show the connection to be more
likely?
Mr. Jackson. The National Sciences Foundation has done
studies on it and presented them yearly for many years.
Mr. Hall. We will make sure we pass it along to the VA.
Mr. Smithson, pertaining to H.R. 3008, in your mind, what
distinguishes rural veterans from veterans in metropolitan
areas that would make this legislation necessary?
Mr. Smithson. I'm sorry. Can you repeat that question?
Mr. Hall. What distinguishes rural veterans from veterans
in metropolitan areas, which would make H.R. 3008 necessary?
Mr. Smithson. They often have a lack of resources, access
to information. They may be far away from a VA facility. They
may also not have access to service officers. A lot of rural
areas have limited resources as far as county service officers
and even veterans service organization service officers.
Mr. Hall. I would imagine the cost of gasoline is probably
complicating things, too
Mr. Smithson. Probably, yes.
Mr. Hall. Mr. Rowan, it sounds like VVA has had an involved
history of advocating for SHAD veterans. What is your response
to the IOM testimony that claims there is no clear evidence
that associates Project SHAD participants with ill health
effects? Does VVA have any additional data, a database of
veterans who report being sick because of SHAD, and how would
you suggest rewording the clause so that it better specifies
the meaning of biological and chemical?
Mr. Rowan. Actually, my friend, Mr. Alderson here, can
probably answer those questions a lot better because they are
much more familiar with it. Other than to say it was not only
the fact of what they used and what the experiments were, but
the cleanup was probably as dangerous as the original
experiment because the caustic chemicals were just as bad.
He has done a whole lot more study on this. One of
interesting things, apparently DoD is starting to catalogue all
these folks who have been exposed to all of these different
programs. We can find out who they were.
Mr. Hall. Let me take the suggestion and ask the same
question of Lieutenant Commander Alderson.
Commander Alderson. Yes, sir. One of the things that was
disappointing to us is that they found that our crews of our
LTs--each LT only had a crew of 10, with a lieutenant as
commanding officer, for a crew of 11.
But they did not count the laboratory people or the gunners
mates who were loading and mixing the weapons, that were
loading them onto the Marine aircraft that were coming over and
escorting us. Those, we felt, were also part of the Project
SHAD technical staff. But if you leave it just to the tug
crews, you come down with this minor number.
If you take the whole Project SHAD technical staff from the
beginning to the end, with normal rotation because this is a
permanent change of duty station, I would guess that there was
somewhere between 400 and 500 veterans.
They also didn't have a ship that they could compare the
LTs to. I gave them the name of the U.S. Koka, which was a
small Navy tug that operated out of the same area that we did
on the docks there in Pearl Harbor.
Mr. Hall. Commander Alderson, given your direct experience
with Project SHAD, what would you like to see done in the way
of followup to give veterans like yourself, who are suffering
as a result of exposure to various elements used during these
experiments, some measure of justice, although delayed justice?
Commander Alderson. First of all, I would like to make sure
that our health is taken care of. In cases where we are talking
about, like Mrs. Pilkinton, she has no widow benefits, and she
is definitely a widow of SHAD because we were there when Larry
got bit.
I would like to see those things happen. I would like to
have--when studies of our operations done and our exposures
examined, I would like to have Commander Norman LaChapelle and
myself, people who were involved in the planning, operation,
and execution of the tests, be part of the panel, at least be
closely consulted with what actually occurred.
I think one of the problems that is with the IOM study is
that they never had a clear idea of what we did and how we did
it. When they tested the rest of the United States Navy ships,
they did not ask the crew what their job was, and the signal
men on the flying bridge certainly had more exposure than the
radar operator in the combat information center, who is in a
temperature, dust and humidity-controlled atmosphere, or the
guy in the firing flat in the boiler room, in the heat. He is
standing under the heavy-duty air flowing down, not only to
give him something to cool off and breathe, but that air goes
in and fires the boiler. So he is under a tremendous amount of
exposure.
This is one of the major errors of trying to equate what
that exposure was during the tests.
Mr. Hall. Speaking as a sailor who has had a number of
power and sailcraft--smaller ones, I am sure--at one time we
had a diesel leak from one of the tanks that sprang a leak, and
it took forever to get the odor out of the hull. No matter how
many times you scrubbed it with different agents, it seemed as
if it permeated the fiberglass, to some degree.
I am sure the same is true of these agents that you were
being tested with.
Commander Alderson. I said that Mrs. Frazier was worried
about her health and her daughter's health. When we were out on
the test, using hot weapons, that was different. When we were
working out of Pearl, and we were training on a daily basis
using some of the same chemicals to clean up with and so forth,
there were no washing machines on the tugs. When Ken came in,
he took off his uniforms and so forth, and Leah washed his
clothes with hers and her daughters.
Mr. Hall. And they were all exposed to lower levels of the
same contaminant?
Commander Alderson. Yes, sir.
Mr. Hall. Or weapon. Thank you very much for your testimony
and for your service and your patience. I am sorry. I guess
this is one of those times when somebody should apologize to
you on behalf of your government. So I will presume to do that.
I get e-mails from some of the test vets on a pretty regular
basis, from all kinds of tests that can't be talked about
because they are so highly-classified or secret, when I hear
secret it kind of has a bad ring to it.
But anyway, I would like to ask Mr. Faull, a 1-year time
period does not seem to take into account the nature of ALS,
since the disease is difficult to diagnose and can in fact go
undiagnosed for some period of time. It is also a disease that
may manifest itself years after discharge, well after younger
veterans leave the service. Do you think the VA's current
policy is adequate?
Mr. Faull. No. As I said, I have been trying to establish
service-connection for over a year now. You heard some of the
testimony today talking of buddy letters, et cetera. I have
given those. I have given the scientific proof. And as I said,
deaf ears.
Mr. Hall. You mentioned the Harvard study and the World
Health Organization (WHO) guidelines. How are these different
from the IOM study?
Mr. Faull. The IOM study was a review of all the studies
done to date. I think as we heard earlier, it was five. And
that looked at all of those studies and said that ALS, as--the
military as related to the development of ALS, it is an
increased risk. The WHO studies, the guidelines were utilized
at least in my case for the vaccinations, and came back as a
possible cause of ALS.
Mr. Hall. Thank you. Thanks again for your service and your
sacrifice. Last, I would like to ask Mr. Woods, in your
statement you identified two problems as a service officer, the
first being with records that are still with the units on
deployment or when documentation simply did not occur. I have
also heard that getting documentation can be difficult when
records are classified. So what do you do as a service officer
when such problems exist? Second, in your opinion does VA give
the veteran the benefit of the doubt as required by statute?
Mr. Woods. I would like to answer that last question first.
No. They definitely do not give the veteran the doubt at all.
It should be that they should believe the veteran more, but
they say, hey, by our records here we don't show it, so they
shoot the veteran down. For me, I have learned now that I can
go ahead and contact, like I said, the unit records section.
Since the records were burned up in the personnel files, the
unit records are still pretty much intact. Also by using the
buddy statements, that is an important thing to use anymore.
Sometimes the VA will accept the buddy statement.
I have had a case where a gentleman came in, complained
about a back injury. He jumped into a trench during incoming
rounds, he had a gentleman land on his back, injured his back,
had a couple of aspirin for it later on. Well, later on in life
it bothered him more, and he remembered about the gentleman
jumping on his back. The VA has no records of it because it was
just, you know, a medic would give him some aspirins and that
was it. We were able to actually track down the two veterans
that were in on the case of jumping on the gentleman's back. I
sent the information to the VA, along with the Social Security
number, and we got a letter back from the VA saying, well, we
need more information. What unit was he with? Because he came
over with a Guard unit, actually, from over in Vietnam. So we
had to send more information in. And it is hard to get them to
accept that.
Mr. Hall. Thank you, sir. My time is long expired. I will
now recognize our Ranking Member, Mr. Lamborn.
Mr. Lamborn. Thank you, Mr. Chairman. First of all, I want
to thank you, Lieutenant Commander Alderson and Mr. Faull, for
your service to our country. This question is for Mr. Rowan and
Mr. Smithson. Understanding that we have some bills here that
can be very beneficial to veterans, we still have to address
the PAYGO issue. How do you suggest that we address PAYGO for
bills, these bills, or bills like this? Help us with this
situation.
Mr. Rowan. One of my concerns about this whole PAYGO
business, and we hear this not only in this, we have been
hearing it in the GI Bill issue as well, we don't hear PAYGO
when we hear how much we have to spend in Iraq every day. We
never hear that. Why? Because it is part of a war. Well, I hate
to say it, but we are all part of a war. We may be coming 20
years after the war or 30 years after the war, but we are all
part of the war. And so I think that I get a little concerned
about PAYGO just as a political issue here being utilized when
it comes to veterans benefits. That is number one.
Number two is oftentimes the veterans benefits, unlike
every nickel that is being spent in Iraq, will actually come
back to help the society. It is given to the veteran. I mean,
the veteran isn't going to run off and just make that money
disappear. He is going to probably use it to pay for the gas
that got increased last month or whatever, to pay for their
life. By the time we end up getting these veterans these
benefits it is oftentimes, and Mr. Woods can tell you, so far
after the fact, when people have usually been beaten down into
destitution, that this is barely compensating to keep them
alive. And yet that money still gets recirculated back in their
community and ends up having some sort of impact.
Having spent a lot of life in government, I can tell you
the economists tell you every nickel you give out ends up
coming back about 16 times in various ways in the economy,
which is why we give all these benefits away to corporations
and things to do things, build things, and move people into
their community. And I think that the veterans benefits, just
again as a practical thing, is part of warfare. And if we are
not willing to pay for it, don't send us anywhere.
Mr. Smithson. I would just like to echo that. It is part of
the cost of war. And several of these bills, it is about doing
the right thing. And for example, H.R. 51--what is it, H.R.
5985, recognizing the change in warfare today, in that for
example the conflicts in Iraq and Afghanistan that anybody over
there in those two theaters are exposed to combat no matter
what they are doing. And changing the law to recognize that is
the right thing. And changing that is a cost of war.
So I understand your concerns about how to pay for it, but
doing the right thing is doing the right thing. And there is
always enough money to send troops into harm's way, but it
seems when it comes time to pay for it after the fact we are
always concerned about that. And again, doing the right thing
is doing the right thing.
Mr. Lamborn. And for the record, I didn't vote for the
PAYGO rule. However, it is something that we are allegedly
following, so I just had to ask that question, or these bills
won't be able to go forward. So, thank you for your answer.
I yield back, Mr. Chairman.
Mr. Hall. Thank you, Mr. Lamborn. For the record, I would
say that once upon a time the conservative approach would have
been to pay for the war rather than have a war on borrowed
money, and also pay for the veterans benefits. So we should
probably be consistent and either pay for them both, all of it,
or borrow all of it. But at any rate, I agree that we cannot
consider the veterans to be separate from the war itself in
terms of its urgency and its worthiness of funding.
Mr. Rowan, you wanted to comment on that?
Mr. Rowan. Yeah, I just wanted to add one other thing with
regards to the gentleman with regards to the ALS. There are
many instances where we see problems with disease that doesn't
necessarily manifest itself until many years after the fact. I
mean, I still get a laugh every time I read the fact when we
talk about the presumptives of Agent Orange, and we had
chloracne, but it has a year time. Well, my year after Vietnam
actually I did, I had all kinds of chloracne, but I didn't know
what the heck it was until 20 years later. So we get all of
these crazy things.
I have often seen, and we even had some adjudicated cases
on it, and we actually won a case on a guy who had heart
disease. And we proved that even though his diabetes came
later, was diagnosed later, we actually proved he was probably
prediabetic, which led to his heart condition, and got the
heart condition as a secondary to the diabetes.
So you got all of these things that take so long to do. And
so I applaud the efforts to try to, especially ALS and
Parkinson's, add them to the list.
Mr. Hall. Thank you so much, Mr. Rowan, and thank you to
our entire panel. We could have a long discussion about this,
but given the lateness of the hour and the fact that there is
another panel waiting, we will save that for another time. You
are excused, and thank you very much for your testimony and
your service to our country.
And we will ask our fourth panel to join us at the table.
Bradley G. Mayes is the Director of Compensation and Pension
Service for the Veterans Benefits Administration (VBA),
accompanied by Bradley B. Flohr, Assistant Director for Policy,
Compensation and Pension Service of the VBA, and Richard
Hipolit, Assistant General Counsel of the U.S. Department of
Veterans Affairs.
Thank you, gentlemen, for your patience, and it is good to
see you again. Welcome. Of course without objection your entire
statement is entered into the record and feel free to deviate,
elaborate, or edit as you wish. Mr. Mayes, you are recognized
for five minutes.
STATEMENT BRADLEY G. MAYES, DIRECTOR, COMPENSATION AND PENSION
SERVICE, VETERANS BENEFITS ADMINISTRATION, U.S. DEPARTMENT OF
VETERANS AFFAIRS; ACCOMPANIED BY BRADLEY B. FLOHR, ASSISTANT
DIRECTOR FOR POLICY COMPENSATION AND PENSION SERVICES, VETERANS
BENEFITS ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS;
AND RICHARD HIPOLIT, ASSISTANT GENERAL COUNSEL, U.S. DEPARTMENT
OF VETERANS AFFAIRS
Mr. Mayes. Thank you, Mr. Chairman, Ranking Member Lamborn.
Before I get started, I did want to recognize the members of
the previous panel and thank them for their service and for
helping educate me, Commander Alderson and certainly Mr. Faull.
We can't know what Mr. Faull is going through, clearly.
I am pleased to be here today to provide the Department of
Veterans Affairs' views on pending benefits legislation.
Accompanying me is Brad Flohr, Assistant Director for Policy in
the Compensation and Pension Service, and Mr. Richard Hipolit,
Assistant General Counsel.
We are still reviewing H.R. 5448, and will provide views on
that bill in a subsequent views letter.
[The VA failed to provide Administration views for H.R.
5448 and H.R. 3795.]
I would like to begin by sharing our views on H.R. 5155,
the ``Combat Veterans Debt Elimination Act of 2008.'' I believe
that was introduced by Congresswoman Shea-Porter. This is the
only bill I will be testifying on today which the
administration is able to support.
This bill would prohibit VA from collecting all or part of
a debt owed to the United States under any program under the
laws administered by VA who dies as a result of a service-
connected disability incurred or aggravated while serving in a
theater of combat operations in a war after the Persian Gulf
War or in combat during a period of hostilities after 9/11.
Regarding H.R. 3008, the ``Rural Veterans Caregiver
Compensation Act,'' VA does support the intent of this proposed
legislation. However, we oppose the bill because we believe it
would duplicate some ongoing efforts by the Veterans Health
Administration's Office of Rural Health to address the
healthcare needs of veterans in rural areas, as well as other
outreach activities that we are conducting for vets in those
rural areas. And further, it would divert existing resources
away from direct service delivery, since there is no provision
to fund this grant program of up to $1 million per State, as I
read the bill.
H.R. 4274, the ``Gold Star Parents Annuity Act of 2007,''
would provide a monthly benefit of $125 to parents of
servicemembers who lost their lives while on active duty in
military operations described by 10 U.S.C. section 1126(a). If
more than one parent is eligible for the benefit, it would be
divided equally among the eligible parents. VA honors the
sacrifice of those who have lost their lives in the service of
their country, and we recognize and honor the supreme sacrifice
of Gold Star parents who have lost a son or daughter serving in
the Armed Forces. However, we don't support the bill because we
don't believe you can put a monetary value of this sort of a
loss to servicemembers' life. And we already do provide a
monthly benefit to certain qualifying parents based on need,
our Parents Dependency and Indemnity Compensation (DIC)
Program. Further, if parents are designated as the beneficiary
of a deceased servicemember, then they are potentially entitled
to DoD's death gratuity and Servicemembers Group Life
Insurance. And these combined have the potential to add up to
$500,000. Clearly, however, no amount of money can compensate
for the sudden loss of a son or daughter.
Regarding H.R. 5709, the ``Veterans Disability Fairness
Act,'' the VA does not support this proposed legislation
because we have already put in place measures that address most
of the subjects covered in the bill. We are conducting quality
reviews on a statistically valid sample of claims across ROs,
Regional Offices. We began routinely monitoring the most
frequently rated diagnostic codes this year, this fiscal year,
to assess consistency of service connection determinations and
degree of disability assigned for various disabilities across
Regional Offices, across jurisdictions. And we conduct regular
site visits. And locally, we pull random samples of cases that
are adjudicated by employees responsible for deciding veterans
claims in the administration of the local performance
management plan.
H.R. 5985, the ``Compensation for Combat Veterans Act,''
would require VA to treat certain veterans as having engaged in
combat with the enemy for purposes of 38 U.S.C. 1154(b), thus
permitting the use of lay or other evidence for proof of
service occurrence of a combat-related disease or injury. The
veterans who would qualify for this treatment are veterans who
during active service with a U.S. military, naval or air
organization during a period of war, campaign or expedition,
served in a combat zone for purposes of section 112 of the
Internal Revenue Code 1986, or a predecessor provision of law.
In essence, the bill would equate that service in a combat zone
with the current stipulation of engaging in combat with the
enemy.
We don't support the bill. The current regs relax the
evidentiary requirements a combat veteran must meet to prove
service occurrence or aggravation, and that language makes it
clear that its purpose is to liberalize the method of proof for
claims based on injuries incurred or aggravated while engaged
in combat with the enemy. This provision recognizes the unique
circumstances of combat which are not favorable for
documentation of injury or illness because treatment for such
injury or illness may be administered in the field. Supporting
evidence is often difficult to obtain when a veteran later
files a claim for disability compensation for a combat-related
disability, hence the provision, as we heard earlier from the
testimony. But this bill contemplates that all veterans in a
combat zone are faced with the same difficulty in documenting
treatment for injury or illness. However, it doesn't appear
that the same difficulty does exist for servicemembers who,
although serving in a combat zone, have access to a medical
facility for treatment and whose treatment would be documented
in service treatment records.
The remaining bills, H.R. 1197, and I won't read the titles
to be expedient, but H.R. 1197, H.R. 3795, H.R. 5454, H.R.
5954, and H.R. 6032 all propose to modify existing presumptive
provisions that are already in place, with the exception of
H.R. 5954, which is the presumption to exposure to biological,
chemical, or other toxic agents as part of Project 112. That
bill contemplates creating a new presumption for veterans who
participated in that project.
Beginning with the latter bill, H.R. 5954, I would like to
begin by correcting my written statement for the record. In my
written statement I indicated that DoD estimates about 6,000
veterans may have been involved in Project 112/SHAD and to date
DoD has provided VA with the names of approximately 5,000
veterans who participated in tests. VA has actually received
the names of 6,440 military personnel who participated in tests
related to Project 112/SHAD. Of this number, 385 could not be
matched to a numeric identifier such as a Social Security
number or service number and 733 were known to have been
deceased. We sent notification letters to all veterans that we
were able to identify, informing them that they had been
identified by DoD as a Project SHAD participant. And we do
continue to work with DoD; however, we are not aware of any
additional test participants.
[Additional Administration views from VA for H.R. 5954
appear on p. 121.]
Regarding presumptives in general, in conclusion, the VA
has a process in place to review the scientific and medical
evidence biennially for those veterans who were potentially
exposed to herbicides in Vietnam or hazardous agents in the
Persian Gulf War. Further, the VA has continuously added
additional presumptive disabilities to the list of conditions
related to internment as prisoner of war, most recently the
addition of atherosclerotic heart disease and stroke and its
complications. VA is not aware of any scientific or medical
literature or study linking diabetes mellitus and/or
osteoporosis to POW service; however, we will look at the
previous testimony and pull those studies to look at them.
We are unaware of any scientific or medical evidence
linking exposure to depleted uranium and the radiogenic
diseases already included as diseases associated with radiation
exposure. Nor are we aware of evidence linking any disease to
participation in Project 112/SHAD.
And finally, the IOM, the Institute of Medicine of the
National Academies has consistently determined that there is
insufficient evidence to associate Parkinson's disease with
herbicide exposure. And ALS, again the evidence doesn't appear
to be sufficient to establish a presumptive condition at this
time.
That concludes my testimony, Mr. Chairman, Ranking Member
Lamborn, and I would be pleased to answer any questions on
these topics.
[The prepared statement of Mr. Mayes appears on p. 89.]
Mr. Hall. Thank you, Mr. Mayes. For scheduling reasons I am
going to yield to or recognize our Ranking Member, Mr. Lamborn,
first for questions.
Mr. Lamborn. Thank you, Mr. Chairman, for taking me out of
order. Mr. Mayes, do veterans who cannot show a service
connection with PTSD, but need and want treatment for PTSD,
whatever its source might have been, do they still receive
treatment? And could you explain what their status is?
Mr. Mayes. Yes. Currently, veterans returning from Iraq and
Afghanistan are entitled to receive treatment for 5 years.
Mr. Hipolit. I believe that is correct.
Mr. Mayes. So it is 5 years after expiration of their term
of service. So it is comprehensive healthcare through the
Veterans Health Administration.
Mr. Lamborn. Okay. How would that apply, or would it apply
to a Vietnam veteran who was in Vietnam in the sixties or
seventies?
Mr. Mayes. Well, I am on the benefits side. I am a little
bit outside of my lane. So in order to be completely correct,
that is a question I would like to take back for the record and
provide you a more thorough response. But I will say this, I
know that if a veteran presents, for example, to a clinic or a
counseling center and they are in distress they are not turned
away.
[The following information from VA was subsequently
received:]
Question: What happens if a Vietnam-era veteran who has not
filed a disability claim for PTSD came to VA seeking care for
PTSD symptoms?
Response: A veteran who comes to VA with a need for medical
care would be assessed based on the nature of his or her needs
and urgency. If the veteran needs treatment, a VA medical
center or clinic can provide care by enrolling the veteran for
care if he or she is in an appropriate priority group or, even
if not, if he or she has urgent or emergent clinical needs. If
the veteran does not meet priority requirements, the veteran
could be referred to a Vet Center if he or she was a war zone
veteran. If not a war zone veteran, the veteran could be
referred to community mental health resources. Any of these
options would lead to diagnostic assessment and possible
service-connection for PTSD, which would then make the veteran
eligible for VA care.
Mr. Lamborn. Thank you. Mr. Chairman, I yield back.
Mr. Hall. Thank you, Mr. Lamborn. Mr. Mayes, would you for
starters just comment on some of the cases that you heard about
today from our previous panel?
Mr. Mayes. Okay. Well, I think one of the questions that
was posed earlier, if my recollection serves me correctly, was
could we service-connect a condition like Mr. Faull's condition
if the Lou Gehrig's disease did not manifest within the current
1-year presumptive period? And we can. What we would need,
though, is medical evidence that would establish a link between
the disease or the disability and military service. And really
that is the premise of this program, of the VA's Disability
Compensation Program, is that we have a disease or injury that
is incurred in, or aggravated by, military service. What
presumptives do is really they lower the threshold, the
evidentiary threshold for certain disorders, disease processes
where it may be difficult to get the evidence. It might be that
we have scientific or medical evidence in the case of some of
the other presumptives that shows a relationship between some
exposure and military service. And therefore, we just go ahead
and extend the presumption. But even if veterans aren't covered
by the presumption or the relaxed evidentiary threshold, we can
still get there, but there just has to be the nexus.
Mr. Hall. As you heard during the questioning of the IOM,
there were inquiries on the proposed new paradigm for
establishing presumptions outlined in its latest report. Can
you inform us of the VA's views on the current manner of
establishing presumptions for disability compensation and the
proposed system offered by the IOM in its 2007 study? What does
VA see as its role in both systems?
Mr. Mayes. First of all, the VA is interested in giving
veterans their due. I want to say that up front. If there is
evidence of causation, if there is evidence that a presumptive
is in order, then in many cases, in the past, we have through
regulations added presumptives to the list of disabilities that
are subject to whatever the exposure or, for example,
radiogenic diseases or Agent Orange.
So we are interested in that science, and Congress has
legislated that the Institute of Medicine will look biennially
at the Agent Orange presumptives and the diseases possibly
associated with Agent Orange and diseases possibly associated
with Gulf War service. So the way that works is that the
Institute of Medicine conducts their study, they look
extensively at the science and literature out there, it is
peer-reviewed, they rely on peer-reviewed research, it is my
understanding, and then they hand that over. We have a working
group of experts, people from the Veterans Health
Administration, Veterans Benefits Administration, the Office of
General Counsel who review that and the recommendations. They
make recommendations to a task force that is comprised of the
Under Secretaries for Health, Benefits, General Counsel, and a
couple of other people that are on that task force. And then
they make a recommendation to the Secretary, and ultimately he
makes the decision. That is the way it works now.
Mr. Hall. Okay. If I could move along.
Mr. Hipolit. If I could just clarify, what we are looking
for in for example, the Agent Orange or Gulf War areas, is a
positive association between the health outcome and the
possible exposure in service. So we don't necessarily need to
prove causation in order to create a presumption. We will do it
based upon a positive association, looking at the credible
evidence for or against the association.
Mr. Mayes. Thank you, Dick.
Mr. Hall. Could you tell us what your position is on the
new system that IOM proposed?
Mr. Mayes. I am not prepared to articulate a position at
this point. That is still being considered within VA.
Mr. Hall. Okay. Whenever you have to the point of having a
position, we would appreciate hearing it.
Mr. Mayes. Absolutely, Mr. Chairman.
[The following information from VA was subsequently
received:]
Question: What is VA's view on the IOM's ideas for changes in
the process for establishment of presumptions that were
discussed in the hearing?
Response: The Institute of Medicine (IOM) published
recommendations in 2008 for changes in the VA process for
establishing presumptive disabilities. The IOM recommendations
include creating two new advisory Committee panels. One would
accept and review nominations for presumptive disabilities from
veteran stakeholders. The other would be an independent
scientific review board with the task of investigating the
scientific basis for establishing any potential presumptive
disability. This scientific panel would base its conclusions on
the existence of a causal relationship between the military
event and the subsequent disability, rather than on just an
association between the military event and the subsequent
disability.
VA views these recommendations as potentially beneficial but
there are some concerns. Of primary concern is the authority of
the Secretary of VA to make a final determination on
establishment of a presumptive disability. Creation of these
panels must be for informational purposes only and must not
interfere with the Secretary's final authority. In addition,
this process would have to be considered in light of
Congressional legislation already enacted that mandates
procedures for establishing certain presumptive disabilities.
The Agent Orange Act 1991, for example, already provides a
process for evaluating potential herbicide related presumptive
diseases. Any implementation of the IOM recommendations must be
integrated with such existing law. There is also a concern that
use of these panels may prolong the actual decisionmaking
process and inhibit the Secretary's ability to provide the
public with a timely response.
Mr. Hall. And I would also like to just quickly ask you a
couple more questions, since I am on the red light already.
Since there is more up to date medical research on Parkinson's
than ALS, it seems that onset does not necessarily occur in a
year. So would section 1113(b) be the most appropriate
provision to apply? What happens when these kinds of cases
occur where the presumptive window has closed for the veteran
claiming service connection for a chronic condition? Does VA
deny chronic conditions simply because of the 1-year issue in
section 1112?
Mr. Mayes. No. We don't deny simply because the presumptive
window has closed. We can't apply the presumption of service
connection because the window has closed. But we look at the
evidence to try and see if there is some kind of link between
the disease and military service. For example, if a clinician
suggested that there were symptoms that they saw in service,
and is now attributing the disease process to those symptoms,
that would be an avenue that we could arrive at service
connection, even if the onset is outside of the presumptive
window.
Mr. Hall. It sounds to me like a legislative change to
extend that 1-year window would make your job easier, because
you wouldn't have to be fishing for a way to get around it in
the case of a disease where frequently, if not most of the
time, the disease is not actually diagnosed or doesn't reach a
point where you can definitively say what it is until after the
1 year has passed.
Mr. Mayes. Yes. It would be easier. The evidentiary----
Mr. Hall. You could spend your time getting the treatment
rolling and moving on to another case instead of going and
trying to get around the 1 year and find a way to get the
person covered.
Mr. Mayes. Of course we have a mandate to ensure that we
are compensating for diseases or disabilities due to service.
Mr. Hall. Right. And we are trying to help you do that. I
appreciate that you want that, and that we are all after the
same thing here.
Does VA track the number of claims it has gotten from
veterans with Parkinson's, ALS, or those exposed to DU or
Project 112?
Mr. Mayes. Well, yes. The claims from Project 112, yes, we
do have those numbers. I don't know if I have those with me. We
know how many letters we sent out to veterans. In fact, I do
have that. But it was between 4,000 and 4,500. So it wasn't the
full amount because we couldn't necessarily definitively
identify the name that was handed us from DoD or we couldn't
get an address.
[The following information from VA was subsequently
received:]
Question: Does VA track claims for Parkinson's, ALS, Depleted
Uranium-connected, and Project SHAD-connected claims? If so,
please provide demographic information on these populations.
Response: VA tracks the number of claims filed in certain
categories and other relevant information in recurring reports.
However, we do not capture demographic information. Available
information is provided below on the requested claim
categories.
1. Parkinson's disease
As of May 2008, VA identified 968 veterans
currently receiving compensation for
Parkinson's disease. The following table
provides the breakdown by the combined
evaluation:
------------------------------------------------------------------------
Comb Evaluation Veterans
------------------------------------------------------------------------
10% 26
------------------------------------------------------------------------
20% 18
------------------------------------------------------------------------
30% 82
------------------------------------------------------------------------
40% 78
------------------------------------------------------------------------
50% 67
------------------------------------------------------------------------
60% 77
------------------------------------------------------------------------
70% 115
------------------------------------------------------------------------
80% 124
------------------------------------------------------------------------
90% 93
------------------------------------------------------------------------
100% 288
------------------------------------------------------------------------
Total 968
------------------------------------------------------------------------
2. Amyotrophic Lateral Sclerosis (ALS)
As of September 2008, VA has identified 871
unique veterans who have submitted a claim for
ALS. The following table provides the
breakdowns by year and decision.
------------------------------------------------------------------------
Fiscal Year Unique Veterans
------------------------------------------------------------------------
FY 2004 133
------------------------------------------------------------------------
FY 2005 184
------------------------------------------------------------------------
FY 2006 148
------------------------------------------------------------------------
FY 2007 183
------------------------------------------------------------------------
FY 2008 227
------------------------------------------------------------------------
3. Depleted uranium
VA does not specifically identify claims for depleted
uranium.
4. Project SHAD
As of September 2008, VA has received 679 Project 112/
SHAD claims; 65 are pending and 614 have been decided.
Mr. Hall. Right. Maybe you could provide us after the fact
additional information on these populations, such as
demographic descriptions and how many have sought treatment. I
wanted to ask you the current backlog stands, as I understand
it, is at about 650,000 cases, claims that are waiting to be
adjudicated. How many of these are for veterans who have been
diagnosed with PTSD but lack a verified stressor? And that may
be something you have to get back to us on, too, but I just
wanted to ask you that question.
Mr. Mayes. I don't know how many claims are pending right
now today for PTSD. I do know the number of veterans who are on
the rolls right now for PTSD. And that is 328--as of the end of
May it was 328,923. And that compared to 1999 of only 122,070.
So we know we are service connecting post traumatic stress
disorder.
[The following information from VA was subsequently
received:]
Question: How many PTSD claims are pending where there is no
verified stressor?
Response: PTSD claims may be pending for several reasons. VA
does not record the number of claims pending where the stressor
has not been verified. Claims are generally pending because
development is being undertaken and evidence gathered.
Mr. Hall. That is probably a good thing.
Mr. Mayes. We think so.
Mr. Hall. Not a good thing they have PTSD.
Mr. Mayes. Yes, Mr. Chairman.
Mr. Hall. But a good thing if they have it as a result of
their service that they be treated and classified.
So in light of the issues we have been discussing regarding
chemical exposures, the Veterans Disability Benefits Commission
(VDBC) recommended that VA create a health registry for
veterans who served at Fort McClellan and were potentially
exposed to PCBs and other chemicals. What are your thoughts on
these findings? What has VA done so far to implement this
recommendation?
Mr. Mayes. I think that is one I would like to take for the
record as well, because I believe it would likely be the
Veterans Health Administration that would create the health
registry and maintain it. So I can take that, and if you will
indulge me, get back with you.
[The following information from VA was subsequently
received:]
Question: What is VA's opinion on the recommendation of the
October 2007 Veterans' Disability Benefits Commission report
that VA initiate a registry and take other action with regards
to possible PCB exposure at Fort McClellan, Alabama?
Response: While VA appreciates the recommendations and work of
the Veterans' Disability Benefits Commission, VA does not
support the creation of such a registry. Creating one is
unlikely to improve the health or otherwise benefit those
veterans who may have been stationed at a U.S. military base
that also had hazardous materials onsite.
VA often hears from individuals and groups of veterans who are
concerned about how their health may have been affected by
exposure to environmental hazards at the U.S. military bases
where they were stationed. The military uses many common
hazardous materials at bases across the country. The U.S.
Environmental Protection Agency (EPA) tracks nearly 1,600
hazardous waste sites across the country, and more than 170 of
these are current or past military bases, including Ft.
McClellan.
Moreover, a recent Department of Defense (DoD) evaluation
concluded that there is little or no PCB contamination
specifically at Fort McClellan that could have led to exposure
of Army personnel.
However, Army personnel living off-base in the nearby town of
Anniston may have been exposed to PCBs located there. That is
why current scientific studies by the U.S. Department of Health
and Human Services (HHS) on the health of Anniston residents,
which include any veterans who may reside there today, are so
important. HHS scientists are currently conducting four studies
that evaluate PCB health effects for Anniston residents,
including neurological health, PCB blood levels, health status
of exposed children and adults, reproductive health issues, and
environmental PCB levels. VA closely monitors these studies,
particularly as they may turn out to relate to the health of
servicemembers who may have been stationed at Fort McClellan.
However, until they are completed, we have little or no data
that would indicate any health problems from PCB exposure
related to military service in or around Anniston.
In addition, it would be difficult to conduct meaningful health
studies of veterans formerly stationed at Fort McClellan, even
if it were possible to establish records of who served there
during the relevant period. This is because of the difficulties
of identifying and locating personnel who served in the
relevant time period, finding accurate information about their
actual exposures, obtaining older military medical records, and
establishing a reasonable ``control'' or comparison group.
Therefore, the ongoing HHS study provides the greatest chance
of identifying a health risk from an environmental exposure.
Fortunately, veterans enrolled for VA healthcare with health
problems related to PCB exposure while on active duty do not
have to wait for such a study to seek healthcare and disability
compensation from VA. The long-term health consequences of
exposure to PCBs are very well documented. If any veteran has
an illness related to PCB exposure and they can provide
evidence that they were exposed during military service, they
would have a good case for a related disability claim.
Fact Sheet
Polychlorinated biphenyls (PCBs) have been identified in at
least 500 of the 1,598 hazardous waste sites that have been
proposed for inclusion on the EPA National Priorities List
(Agency for Toxic Substances and Disease Registry, U.S.
Department of Health and Human Services, Toxicological Profile
for Polychlorinated Biphenyls (PCBs), November 2000,
www.atsdr.cdc.gov/toxprofiles/tp17.html).
An analysis of the hazardous waste sites listed by HHS Agency
for Toxic Substances and Disease Registry (ATSDR) indicates
that 173 sites are current or past military sites, where
military personnel could have been exposed to hazardous
substances. One of these 173 sites was Ft. McClellan.
A recent report from DoD's U.S. Army Center for Health
Promotion and Preventive Medicine Information Paper, MCHB-TS-
RAO, 13 July 2006, ``Polychlorinated Biphenyls (PCB)
Environmental Contamination Sources at Ft. McClellan, Alabama
and Surrounding Areas'') concluded that ``there is little or no
environmental contamination at Ft. McClellan that may have
exposed Army personnel at Ft. McClellan to PCBs.'' However,
they also pointed out that ``Army personnel who have previously
resided or currently reside within the identified contaminated
areas in [the town of] Anniston may have been exposed to
concentrations above EPA action levels and suffer an elevated
health risk equivalent to the local non-Army population.'' That
is why the current ongoing HHS study on the health of Anniston
residents is particularly relevant.
The U.S. Department of Health and Human Services, Agency for
Toxic Substances and Disease Registry (ATSDR) has a series of
four studies now underway at Anniston, and VA has been
regularly in contact with the investigators for this study to
monitor its progress and results.
The first is looking at neurological health among adolescents
at Anniston, along with measuring blood levels of lead and
PCBs. The study is also checking the health status and exposure
of their parents.
The second study is looking at the health of 1,200 adults for
all health outcomes, with a particular focus on type 2
diabetes, as well as PCB blood levels.
The third study is looking at reproductive health issues among
women and children in Anniston.
The fourth study is monitoring for PCBs in the environment, a
sort of ``geo-environmental'' analysis, with a focus on
schools, etc.
Mr. Hall. That would be wonderful. Thank you.
Last year IOM recommended that VA improve the quality of
the claims adjudication process and improve its accuracy. As we
heard from IOM, accuracy was 88 percent in 2006. Do you know
what it is now? And what is the target?
Mr. Mayes. Well, I believe the 88 percent number referred
to the rating accuracies. So that would be the entitlement
determinations. And I believe we are still at 88 percent.
Mr. Hall. Okay. Do you have a target?
Mr. Mayes. Yes, sir, we do. I believe it is 92 percent. The
target is 92 percent. Now, I might add that we--Congress has
been generous, and we have been able to hire over 3,000
employees. And so what we see happening is we have an influx of
new employees into the work force. And we are trying to get
them up to speed, but their decisions are considered just as
well as those decisions made by journey level decisionmakers.
So it is, I believe, having some impact.
Mr. Hall. Well, you are welcome.
Mr. Mayes. Thank you.
Mr. Hall. And we want to help, as you can tell.
Last, I wanted to say and ask, you mentioned the VDBC
report and the Center for Naval Analysis (CNA) analysis on
training, which was complimentary in comparison with other
Federal agencies. However, you did not address the Commission's
concerns with the emphasis on production over training, which
is complicated by the turnover rate and the inexperience of
raters. How is the VBA addressing these issues?
Mr. Mayes. Well, we frequently hear this. Brad Flohr and I
both have been employees in the field. When you have veterans
like we heard from today who have claims that are pending and
you know they are behind you waiting for a decision, you want
to push those through. I mean our employees don't like having
this backlog. So there is a press to move the work. What I can
say is that we manage individual performance by holding our
employees accountable. We have a standard. And that standard
includes both production and quality. So we do, on an
individual basis at the RO, sampling. We pull cases, we review
for quality. And an individual employee can be terminated,
worst case scenario can be terminated for poor quality just as
well as they can be for lack of production. So they have to do
both, and they want to do both.
Mr. Hall. Good. Well, thank you very much. I would like to
turn to my new Ranking Member, Mr. Bilirakis, for his
questions. Mr. Bilirakis.
Mr. Bilirakis. Thank you. Thank you, Mr. Chairman. I
appreciate it. Director Mayes, in your written testimony you
state that the VA does not support H.R. 1197 because of the
timeline for the VA to make determinations and publish
regulations for establishing procedures for determining future
presumptions for POWs. You said that it was untenable. You also
stated the VA is not aware of any credible scientific
literature to show an association between the medical
conditions covered in H.R. 1197 and POW internment.
I was surprised by the VA's opposition to my legislation
because the VA's previous testimony on H.R. 348 supported the
bill. And my staff will give you the VA's previous testimony.
In 2004, the VA testified, and I quote here, ``it strongly
supports enactment of section 2(c) of H.R. 348, providing that
Congress can find offsetting savings. No one can reasonably
doubt that the stresses and privations endured by prisoners of
war take heavy tolls on their health in ways that may never be
fully understood. The majority of POWs, are aging veterans of
World War II who are unable to wait for science to provide
definitive answers. Moreover, former POWs as a group do not
benefit from relatively relaxed statutory standards, such as
the positive association standard applied in the case of all
Vietnam veterans because of their potential for exposure to
defoliants used there. So for weighing the scientific evidence
regarding associations between their service experience and
later occurring diseases. There is some scientific evidence
suggesting an association between the POW experience and each
of the illnesses covered by the bill, which is 348 in 2004. And
because these veterans are particularly deserving of special
consideration, they too should be afforded the benefit of the
doubt''.
Since my bill is virtually identical to H.R. 348, why is
the VA now opposing this language? And what has occurred to
justify the change in position? That is my first question.
Mr. Mayes. The testimony that we submitted cited the
reasons for the opposition. I do not know what the rationale
was back in 2004. I know that was about the time I think that
we actually added stroke and atherosclerotic heart disease. It
might have been 2005. But I am going to go back and look, and I
can provide you a more definitive answer.
Mr. Bilirakis. Okay. Can you please get back to me?
Mr. Mayes. Yes, sir. We will do that. We will reconcile
those differences.
[The following information from VA was subsequently
received:]
Question: Please explain why VA supported H.R. 348 in 2004 yet
opposed a very similar bill (H.R. 1197) today. Why are the
costs estimated by VA so much higher for H.R. 1197 than the
previous bill?
Response: VA did support the addition of cardiovascular disease
and stroke to the presumptive list for former POWs (FPOWs) in
H.R. 348 and those conditions were subsequently added by
amendment to statute and regulations. VA also did not oppose
the addition of the other diseases mentioned in H.R. 348
although there was no strong evidence identified that would
support an association between the POW experience and
subsequent disease development.
H.R. 1197, however, would eliminate the requirement of any
minimum internment periods. A veteran who was held 1 day or
even a few hours could be service-connected for diseases that
are generally associated with nutritional deficiencies
associated with extreme deprivation. Additionally, VA remains
unaware of any peer-reviewed studies that associate FPOW
experiences with the subsequent development of Type II diabetes
mellitus. Therefore, we do not support the addition of this
condition to the presumptive list. Subsequent to our testimony
on this legislation, however, the Secretary has become aware of
studies that provide a basis for determining that an
association exists between FPOWs who were held in captivity for
30 days or more and the subsequent development of osteoporosis.
VA has drafted regulations to add this condition to the list of
recognized presumptive conditions.
In estimating the cost for H.R. 1197, VA applied prevalence
rates for osteoporosis and diabetes to more precisely identify
the population of veterans and survivors that would apply for
and be granted benefits. As a result, the population changed
significantly from the earlier estimate. Additionally, the
impact of the presumptions for POWs was revised. When providing
a cost estimate for the earlier bill, we assumed the average
service-connected disability payment was at the 30 percent
level, resulting in a combined 50 percent disability rating.
Currently the average disability payment for FPOWs is estimated
to be at the 40 percent level, which we anticipate would raise
the combined evaluation to 60 percent. In terms of monthly
disability compensation benefit payments, a disability payment
for the 50 percent combined evaluation 4 years ago was $646,
while a monthly disability payment for a 60 percent combined
evaluation currently is $921. The survivors benefit amount has
also increased from $967 to $1091.
Mr. Bilirakis. Okay. And then in 2004 the VA estimated that
H.R. 348, on the same subject, would cost approximately $589
million over 10 years. H.R. 348 would have established
presumptions for five conditions, heart disease, stroke, liver
disease, Type 2 diabetes, and osteoporosis. The VA is now
submitting that H.R. 1197, which establishes presumptions for
only two conditions, Type 2 diabetes and osteoporosis, will
cost almost $800 million over 10 years. Although I realize it
has been over 4 years since the VA's last estimate, I am
puzzled by this. As I said, our bill only covers the two
presumptions. So if you can get back to me on that I would
appreciate it as well.
Thank you very much. Thank you, Mr. Chairman.
Mr. Hall. Thank you, Mr. Bilirakis. And we thank you for
your patience, Mr. Mayes, Director Mayes, Mr. Flohr and Mr.
Hipolit. Thank you for being here and for your testimony. We
look forward to receiving the written responses that we have
asked for. Thank you for your insight and opinions. And this
hearing stands adjourned.
[Whereupon, at 5:16 p.m., the Subcommittee was adjourned.]
A P P E N D I X
----------
Prepared Statement of Hon. John J. Hall, Chairman,
Subcommittee on Disability Assistance and Memorial Affairs
Good Afternoon.
The Veterans' Affairs Disability Assistance and Memorial Affairs
Subcommittee Legislative Hearing will now come to order.
I would ask everyone to rise for the Pledge of Allegiance--flags
are located in the front of the room.
I would first like to thank the witnesses for coming today to
appear before the Disability Assistance and Memorial Affairs'
Subcommittee for our fifth legislative hearing. Today we will examine
11 bills which I will identify by bill number for the sake of brevity:
H.R. 1197, H.R. 3008, H.R. 3795, H.R. 4274, H.R. 5155, H.R. 5448, H.R.
5454, H.R. 5709, H.R. 5954, H.R. 5985 and H.R. 6032.
As a preliminary, I ask unanimous consent that Mr. Filner, Mr.
Brown and Mr. Space be invited to sit on the dais for today's hearing.
Without objection, so ordered.
I know the issues addressed in these bills are of utmost importance
to many of you in attendance today, who like me, have constituents or
loved ones who are directly impacted by the problems they seek to
solve.
The subjects of the bills range from establishing presumptions of
service-connection for certain diseases to loan forgiveness for
veterans who die in combat. I look forward to hearing the informed
testimony of our invited witnesses today.
Speaking of invited witnesses, I must express my disappointment
that the DoD did not find it ``efficient'' to provide a witness to
testify, particularly on legislation that has clear DoD implications.
Moreover, this notice came late last week after testimony was due and
after the DoD originally indicated that it intended to provide a
witness. I hope to avoid this unnecessary wrangling in the future. Our
veterans should be important to every implicated Federal agency. The
nexus between the DoD and VA are undeniable and should not be rebuffed
by the DoD when we are attempting to examine issues that overlap on
jurisdiction and responsibility.
I note that yesterday the DoD did provide a written statement for
the record. This fact aside, this Congress deserves the right to
question the appropriate DoD personnel in person, not just in writing.
Not to mention that our men and women who have given their all in
service to our country deserve the right to have their elected
representatives question the executive branch. This is how our system
of checks and balances must work to ensure our democratic way of
governing remains intact.
As I know that many of you in attendance are eager to ask questions
of, or to hear answers from our knowledgeable witnesses, I will reserve
the rest of my time for questioning. Since we have eleven bills under
consideration today, I'll let everyone know how I intend to proceed.
After Mr. Lamborn gives his opening statement, I will recognize Members
of the Committee who have legislation pending before the Subcommittee
today. I ask that other Members of the Subcommittee that do not have
legislation pending to please submit your statements for the record.
We will then proceed to Panel I to receive testimony from our
colleagues who have sponsored legislation pending before the DAMA
Subcommittee. We will then proceed to panels II, III and IV each to
follow by a round of questions where each Member on the dais will be
offered 5 minutes to ask questions of the witnesses on that panel, in
order according to the Rules of the House.
I now recognize Ranking Member Lamborn for his Opening Statement.
Prepared Statement of Hon. Doug Lamborn, Ranking Republican Member,
Subcommittee on Disability Assistance and Memorial Affairs
Thank you Mr. Chairman for yielding and I thank you and your staff
for holding this hearing today.
This afternoon, we are considering several pieces of legislation,
all of which are of interest and potential value.
While I do have some policy concerns regarding a number of the
provisions, I am primarily struck by the mandatory offsets that would
be necessary to pass many of these bills under PAYGO rules.
Mr. Chairman as you know from the PAYGO problems with H.R. 5892, it
is always a challenge to find offsets within our jurisdiction and that
is something we need to keep in mind as we examine these bills today.
The main policy concern I wish to express is that some of the
provisions before us are similar to section 101 of H.R. 5892, in that
they would redefine combat with the enemy as it pertains to section
1154 of title 38.
Mr. Chairman, my concerns with these types of provisions are not
new to you or other Members of the Committee and I will not reiterate
them here, except to point out that a loose definition of combat would
diminish the immeasurable sacrifice and service of those who actually
did face combat.
While I understand and appreciate the effort to address problems
regarding the VA claims backlog, I believe that they generally result
from procedural issues and we should address the problems accordingly.
On another note, I look forward to the testimony of the
representatives from the Institute of Medicine who will hopefully
enlighten the Subcommittee about the process involved in establishing a
presumption of service-connection for certain illnesses and
disabilities.
Experts at VA and IOM have years of experience in dealing with
these issues, and I think it is important for Congress to avail itself
to their expertise whenever possible.
Mr. Chairman I extend my thanks to you and your staff for holding
this hearing and I look forward to hearing the testimony of our
colleagues and the other witnesses today. I yield back.
Prepared Statement of Hon. Michael Thompson,
a Representative in Congress from the State of California
Thank you, Chairman Hall and Ranking Member Lamborn, for holding
this hearing. I introduced H.R. 5954 along with Congressman Denny
Rehberg to allow veterans who were unknowingly used as guinea pigs in
chemical and biological tests by their own government to seek medical
care and compensation for their resulting illnesses. These tests--known
as Project 112, which included Project SHAD, exposed at least 6,000
servicemembers without their knowledge to extremely harmful chemical
and biological weapons--and we believe there are many more veterans out
there that don't even know they were exposed. However, the Department
of Veterans Affairs routinely rejects their claims for medical care and
compensation. Our legislation will finally correct this injustice and
get these men treatment they earned by honorably serving their country.
I am honored that my constituent and former tug boat commander Jack
Alderson is here to testify today and share his first-hand knowledge of
Project SHAD with you. Jack has been a tireless advocate for the
veterans who were subjected to these tests and has kept in touch with
many of them.
When I first questioned the Department of Defense (DoD) in late
1999, they told me that Project SHAD did not exist. Then I was told
that the tests existed, but only simulants were used. Finally, after 3
years of investigating, the DoD finally revealed that these tests
involved live agents, in some cases Vx and Sarin nerve gases and E.
Coli, along with a whole host of other substances known to cause
extreme illness in humans. But despite these shocking revelations, the
DoD has without reason stopped looking for records of Project 112
service personnel and notifying the veterans subjected to these tests.
The VA still does not recognize any long-term health consequences from
exposure to these agents. As Jack Alderson will testify today, members
of his crew and other affected servicemembers have since developed
abnormal cancers and acute respiratory issues but are routinely
rejected by the VA.
You will also hear today from Dr. Judith Salerno, Executive
Director of the Institute of Medicine. In 2002, Congress directed and
appropriated $3 million for the IOM to conduct a study of the health
effects associated with the chemicals used during Project SHAD. Dr.
Salerno will tell you that after 5 years of research, the IOM found no
connection between the substances tested and the health problems of the
SHAD veterans. With all due respect to IOM, I strongly believe their
findings to be unsound. During the briefing on the IOM report, and
utilizing the expertise of SHAD veterans Jack Alderson and John Olson,
Congressman Rehberg and I identified serious deficiencies in the
protocol used by IOM. For example, the health records of deceased
Project SHAD veterans, who may have died as a result of health effects
stemming from exposure during Project SHAD, were not examined. Such an
omission could have a large impact on the results of the study. I
hereby enter into the hearing record the letter sent to Dr. Rick
Erdtmann of the IOM, which further outlines these issues and requests
that the study be reopened. It is my understanding from the IOM that
their review is ongoing and I look forward to hearing their results.
But in the meantime, I want to also enter into the record a
bibliography of fact sheet after fact sheet that have been prepared by
other agencies and departments within U.S. Government that say exposure
to these substances do in fact have long-term health consequences.
It is incumbent upon Congress to ensure that any servicemember who
participated in these tests is provided with treatment if they have
health problems associated with these tests. We can not wait any
longer, considering many of these brave men who served their country
are now sick or have even passed away. Project 112 and similar cases of
chemical and biological testing on servicemembers is an issue of trust
and integrity. How can we expect the current generation of soldiers to
put their lives on the line knowing that harm from the enemy may not be
the only danger they encounter? Jack and other crewmembers are
beginning or have already experienced health problems that may be
associated with these tests, and every day that we wait, I fear that
these brave veterans grow sicker. Thank you for your time and
consideration of this very important bill. It is imperative for us to
right our government's past wrongs and help these brave veterans who
unknowingly participated in these tests.
______
Congress of the United States
U.S. House of Representatives
Washington, DC.
February 15, 2008
Dr. Rick Erdtmann, Director
Board on Military and Veterans Health
Medical Followup Agency
Institute of Medicine of the National Academies
500 Fifth Street, N.W.
Washington, D.C. 20001
RE: Institute of Medicine (IOM) Study Long-Term Health Effects of
Participation in Project SHAD
Dear Dr. Erdtmann:
In November 2007, you and Dr. Bill Page briefed us on the results
of the June 2007 IOM study that had been requested by the Congress. The
study looked at the long term health effects on veterans exposed during
the operation of Project SHAD (Shipboard Hazard and Defense). As you
know, the study failed to link Project SHAD to health problems
experienced by veterans exposed during the testing project. During our
briefing, and utilizing the expertise of SHAD veterans Jack Alderson
and John Olson, we identified what we believe to be deficiencies in the
protocol and requested that IOM reopen the study. This letter outlines
the principal concerns we discussed and represents a formal request to
reopen the IOM study.
1. The study acknowledges that ``up to five Army light'' tug boats
participated in ``several'' Project SHAD tests, but it claims that
complete personnel rosters were never found by the Department of
Defense (DoD) or by IOM. According to SHAD veterans, the rosters were
provided. For instance, a roster of personnel involved in the 1965
Shady Grove test, approximately 106 participants, was provided to IOM
and confirmed by DoD. With the rosters identified and made available,
we would expect the personnel to be considered in the study.
2. Personnel that were not exposed during Project SHAD were
included in the study: a) the USS Granville S Hall (YAG 40), the Desert
Test Center Command and Laboratory ship, was not exposed during Project
SHAD; b) the USS George Eastman (YAG 39), participated only in some
Project SHAD tests and not in others. We believe the inclusion of
personnel from these two ships compromises the study results. We
request that IOM examine how the inclusion of sterile personnel may
have affected the results.
3. The health records of deceased Project SHAD Technical Staff,
who may have died as a result of health effects stemming from exposure
to Project SHAD, were not examined. We would like you to determine if
the cause of death information for those individuals is available and
measure what impact that information would have on the results of the
study.
4. The study failed to account for the job and duty assignments of
various personnel on board the ships, which resulted in different
levels of exposure. Consideration should be given to the fact that
personnel had different levels of exposure during training and testing
to multiple weapons, experimental vaccines, trace elements, simulants,
and decontamination agents. These considerations should be factored in
to gain the most accurate results.
5. The description of the tests performed does not reflect the way
in which the SHAD test was actually conducted. SHAD veterans must be
consulted to ensure that any existing misconceptions in the IOM study
are rectified.
Finally, the IOM study delineated a number of conclusions that were
reached after classified material was reviewed by you and Mr. Don
Burke. (See the IOM Study, p. 8-9.) SHAD veterans contest some of these
conclusions, such as the conclusion regarding animal studies, as well
as the one regarding vaccines. We request that these specific concerns
be discussed more fully at the working group agreed to at the meeting,
which will include representatives from DoD, IOM, selected SHAD
veterans, and our staff.
We appreciate the briefing you provided and your willingness to
review the items described above. By this letter, we formally request
that IOM initiate the necessary steps to reopen the IOM study, and to
work with DoD, as well as Project SHAD veterans, to address the above-
referenced concerns. If you have additional questions, please contact
our staff, Tracy Varghese at (202) 226-7372 or Brent Mead at (202) 225-
3211.
Sincerely,
Mike Thompson
Member of Congress
Dennis Rehberg
Member of Congress
------
Bibliography of Facts Sheets of Chemical and Biological Agents used in
Project SHAD
``Health Effects of Project SHAD Biological Agent: Bacillus
Globigii,'' The National Academies, 2004, Contract No. IOM-2794-04-001.
``Health Effects of Project SHAD Chemical Agent: Betapropiolactone
[CAS #57-57-8],'' The National Academies, 2004, Contract No. IOM-2794-
04-001.
``Health Effects of Project SHAD Biological Agent Coxiella Bumetii
[Q-Fever],'' The National Academies, 2004, Contract No. IOM-2794-04-
001.
``Calcium Hypochlorite, CAS #7778-54-3; Sodium Hypochlorite, CAS
#7681-52-9,'' Fact Sheet prepared by Agency for Toxic Substances and
Disease Registry, U.S. Department of Health and Human Services, Public
Health Service, April 2002.
``Calcium Hypochlorite (CaCl202)/Sodium Hypochlorite, (NaOCI), CAS
7778-54-3/7861-52-9; UN 1748/1791,'' Agency for Toxic Substances and
Disease Registry, U.S. Department of Health and Human Services.
``Di(2-ethylhexyl) phthalate (DEHP), CAS #117-81-7,'' Fact Sheet
prepared by Agency for Toxic Substances and Disease Registry, U.S.
Department of Health and Human Services, Public Health Service,
September 2002.
``Concise International Chemical Assessment Document 52: Diethyl
Phthalate,'' World Health Organization, Geneva, 2003.
``Chemical Information Profile for Diethyl Phthalate [CAS No. 84-
66-2]: Supporting Nomination for Toxicological Evaluation by the
National Toxicology Program,'' National Institute of Environmental
Health Sciences, National Institutes of Health, U.S. Department of
Health and Human Services, November 2006.
``Diethyl Phthalate, CAS #84-66-2,'' Fact Sheet prepared by Agency
for Toxic Substances and Disease Registry, U.S. Department of Health
and Human Services, Public Health Service, September 1996.
``Bis(2-ethylhexyl) Phosphate, CAS No. 298-07-7,'' International
Programme on Chemical Safety, October 2001.
``Escherichia coli,'' Centers for Disease Control, Department of
Health and Human Services, March 27, 2008.
``Ethylene Oxide, CAS #75-21-8,'' Fact Sheet prepared by Agency for
Toxic Substances and Disease Registry, U.S. Department of Health and
Human Services, Public Health Service, July 1999.
``Formaldehyde, CAS #50-00-0,'' Fact Sheet prepared by Agency for
Toxic Substances and Disease Registry, U.S. Department of Health and
Human Services, Public Health Service, June 1999.
``Health Effects of Project SHAD Chemical Agent: Methyl
Acetoacetate, CASD #105-45-3,'' The National Academies, Spring 2004,
Contract No. IOM-2794-04-001.
``Health Effects of Project SHAD Biological Agent: Pasteurella
[Francisella] Tularensis [Tularemia],'' The National Academies, Spring
2004, Contract No. IOM-2794-04-001.
``Health Effects of Project SHAD Chemical Agent: Phosphorus-32
[Radiotoxic Effects],'' The National Academies, Spring 2004, Contract
No. IOM-2794-04-001.
``Q-Fever,'' Centers for Disease Control, Department of Health and
Human Services, February 13, 2003.
``Health Effects of Project SHAD Biological Agent: Serratia
Marcescens,'' The National Academies, 2004, Contract No. IOM-2794-04-
001.
``FDA Warns Public of Contaminated Syringes,'' Press Release, U.S.
Food and Drug Administration, January 25, 2008.
``Staphylococcal Food Poisoning,'' Centers for Disease Control,
Department of Health and Human Services, March 29, 2006.
``Sulfur Dioxide, CAS #7446-09-5,'' Fact Sheet prepared by Agency
for Toxic Substances and Disease Registry, U.S. Department of Health
and Human Services, Public Health Service, June 1999.
``Tularemia,'' Centers for Disease Control, Department of Health
and Human Services, October 7, 2003.
``Toxicologic Assessment of the Army's Zinc Cadmium Sulfide
Dispersion Tests: Free Executive Summary,'' National Academy of
Sciences, 1997.
Prepared Statement of Hon. Denny R. Rehberg,
a Representative in Congress from the State of Montana
H.R. 5954--To grant presumption of service connection to veterans
of Project 112, including Project SHAD.
Thank you Mr. Chairman and Members of the Subcommittee for allowing
me to testify today on my legislation, H.R. 5954, to grant presumption
of service connection to veterans of Project 112, including Project
SHAD.
I would also like to thank Representative Mike Thompson, who has
been a tireless advocate on this issue. It has been my pleasure to work
with him to bring these tests to light and fight to get Project 112/
SHAD veterans the benefits they deserve.
When I was first elected to the House of Representatives in 2001, I
was approached by Billings resident John Olsen. John told me a
disturbing tale of a government refusing to be accountable for its
actions, a long line of healthcare problems, and a lack of care.
In the early Cold war era, the Department of Defense and other
Federal agencies conducted a series of tests called Project 112. During
these projects, a number of weapons containing chemical and biological
agents such as VX nerve gas, Sarin Nerve Gas and E. Coli were tested on
unknowing military personnel. John is one of the victims. Over the
years, he has battled several health problems including skin cancer,
prostate cancer, and an adrenal tumor the size of his fist.
Even worse, for more than 40 years the existence of these tests was
denied by the Department of Defense (DoD), despite reports from
participating veterans, like John, that they were being stricken with
unusual diseases. During that time, many of these veterans suffered and
died while their government looked the other way. Finally, in 2001, the
DoD acknowledged that the tests took place. However, the Veterans
Administration (VA) still wouldn't provide these veterans with health
benefits and compensation for their diseases.
Instead, the VA commissioned a study which was conducted by the
Institute of Medicine. Representative Thompson and I have questioned
the validity of this study as it relates to the long term health
effects on veterans of Project SHAD. Without going into too much
detail, the study did not accurately portray the method in which these
tests were conducted, and did not include sailors from the light tug
boats participating in the tests and which my constituent John Olson
served on. This was a deeply flawed study that should not be used as a
basis to deny benefits to these veterans.
While working on this issue, I've been alarmed by the deficiency of
the program for notifying Project SHAD veterans of their exposure. Due
to pressure from Congress, initial search efforts began in 2000;
however, they were and continue to be inadequate bordering on
negligent.
Since 2003, the Department of Defense has stopped actively
searching for individuals who were potentially exposed to chemical or
biological substances during Project 112/SHAD. At that time, the
Department of Defense reported it had identified 5,842 servicemen and
estimated another 350 civilians were exposed during these tests.
Since the 2003 report to Congress an additional 598 veterans of
these tests have been identified as potentially exposed. 394 were found
in the June 2007 Institute of Medicine study, 165 were provided by
various veterans' advocacy organizations, and another 39 were found
through the Government Accountability Office's efforts. All told, since
the Department of Defense stopped looking, 598 veterans have been
identified, 10 percent of the original total. Put simply, we do not
know how many more veterans may be out there.
It is a true tragedy that our government, after exposing these
servicemen and women to a witch's brew of chemicals, cannot be bothered
to find and notify them of such.
As I mentioned earlier, the Department of Defense did identify
around 350 civilians who were potentially exposed during the course of
these tests. However, to date, no effort has ever been made to notify
these civilians.
H.R. 5954, in addition to the well-deserved presumption of service
connection designation, would begin to draw a circle around the problem
and correct it by implementing the recommendation from a February 2008
GAO report on Project SHAD. The Department of Defense must reopen its
search and notification efforts, or provide an adequate cost-benefit
analysis as to why not.
This legislation will help set a standard of oversight for the
Federal Government's treatment of our soldiers. We can't sweep the
suffering of these veterans under the rug. We can fix the problem
created 40 years ago, and this legislation will do that.
Again, thank you for allowing me the opportunity to testify. And
with unanimous consent I would also like to include the written
statement of John Olsen for the record.
[The prepared statement of Mr. Olsen appears on p. 108.]
U.S. Government Accountability Office
Report to Congressional Requesters
``CHEMICAL AND BIOLOGICAL DEFENSE: DoD and VA Need to Improve Efforts
to Identify and Notify Individuals Potentially Exposed During Chemical
and Biological Tests: Chemical and Biological Defense''
February 2008, GAO-08-366
GAO Highlights
Why GAO Did This Study
Tens of thousands of military personnel and civilians were
potentially exposed to chemical or biological substances through
Department of Defense (DoD) tests since World War II. DoD conducted
some of these tests as part of its Project 112 test program, while
others were conducted as separate efforts. GAO was asked to (1) assess
DoD's efforts to identify individuals who were potentially exposed
during Project 112 tests, (2) evaluate DoD's current effort to identify
individuals who were potentially exposed during tests conducted outside
of Project 112, and (3) determine the extent to which DoD and the
Department of Veterans Affairs (VA) have taken action to notify
individuals who might have been exposed during chemical and biological
tests. GAO analyzed documents and interviewed officials from DoD, VA,
the Department of Labor, and a veterans service organization.
What GAO Found
Since 2003, DoD has stopped actively searching for individuals who
were potentially exposed to chemical or biological substances during
Project 112 tests, but did not provide a sound and documented basis for
that decision. In 2003, DoD reported it had identified 5,842
servicemembers and estimated 350 civilians as having been potentially
exposed during Project 112, and indicated that DoD would cease actively
searching for additional individuals. However, in 2004, GAO reported
that DoD did not exhaust all possible sources of information and
recommended that DoD determine the feasibility of identifying
additional individuals. In response to GAO's recommendation, DoD
determined continuing an active search for individuals had reached the
point of diminishing returns, and reaffirmed its decision to cease
active searches. This decision was not supported by an objective
analysis of the potential costs and benefits of continuing the effort,
nor could DoD provide any documented criteria from which it made its
determination. Since June 2003, however, non-DoD sources--including the
Institute of Medicine--have identified approximately 600 additional
names of individuals who were potentially exposed during Project 112.
Until DoD provides a more objective analysis of the costs and benefits
of actively searching for Project 112 participants, DoD's efforts may
continue to be questioned.
DoD has taken action to identify individuals who were potentially
exposed during tests outside of Project 112, but GAO identified four
shortcomings in DoD's current effort. First, DoD's effort lacks clear
and consistent objectives, scope of work, and information needs that
would set the parameters for its effort. Second, DoD has not provided
adequate oversight to guide this effort. Third, DoD has not fully
leveraged information obtained from previous research efforts that
identified exposed individuals. Fourth, DoD's effort lacks transparency
since it has not kept Congress and veterans service organizations fully
informed of the progress and results of its effort. Until DoD addresses
these limitations, Congress, veterans, and the American public cannot
be assured that DoD's current effort is reasonable and effective.
DoD and VA have had limited success in notifying individuals
potentially exposed during tests both within and outside Project 112.
DoD has a process to share the names of identified servicemembers with
VA; however, DoD has delayed regular updates to VA because of a number
of factors, such as competing priorities. Furthermore, although VA has
a process for notifying potentially exposed veterans, it was not using
certain available resources to obtain contact information to notify
veterans or to help determine whether they were deceased. Moreover, DoD
had not taken any action to notify identified civilians, focusing
instead on veterans since the primary impetus for the research has been
requests from VA. DoD has refrained from taking action on notifying
civilians in part because it lacks specific guidance that defines the
requirements to notify civilians. Until these issues are addressed,
some identified veterans and civilians will remain unaware of their
potential exposure.
What GAO Recommends
GAO suggests that Congress direct DoD to develop guidance to notify
potentially exposed civilians. GAO also recommends that DoD and VA take
steps to improve their efforts to more effectively identify and notify
individuals. DoD and VA generally agreed with most of the
recommendations. However, DoD did not agree with the recommendation to
conduct a cost-benefit analysis regarding additional Project 112
research. As a result, GAO suggests that Congress direct DoD to conduct
such an analysis.
To view the full product, including the scope and methodology,
click on http://www.GAO-08-9366. For more information, contact Davi M.
D'Agostino at (202) 512-5431 or [email protected].
Prepared Statement of Hon. Zachary T. Space,
a Representative in Congress from the State of Ohio
Thank you, Chairman Hall, Ranking Member Lamborn, and Members of
the Subcommittee, for providing me with the opportunity to speak in
favor of H.R. 5709, the ``Veterans Disability Fairness Act.''
At the end of last year, the Oversight and Investigations
Subcommittee held a hearing on an Institute for Defense Analyses report
regarding the average disability payments received by veterans in each
state.
The hearing revealed that the VA's current data is lacking, and
that ``regional cultures'' may be partly to blame for similarly
disabled veterans receiving different ratings and thus, different
disability payments. I introduced legislation specifically geared to
correct these discrepancies.
The Veterans Disability Fairness Act:
Requires the VA to collect and monitor regional data on
disability ratings.
Requires the VA Secretary to conduct reviews and audits
of the rating system.
Requires the VA to submit a report yearly to Congress to
track the progress of the program; and
Requires VA raters to take ownership of their ratings by
assigning identification codes to all adjudications. The performance of
specific raters will then be evaluated periodically for consistency and
accuracy.
The current shortchanging in ratings is not reflective of our
heroes' service, and there is no reason that a veteran from one state
should receive less than veterans in other states. This legislation is
an important step in addressing these issues and in providing needed
oversight.
Additionally, H.R. 5709 supplements this Subcommittee's work on
Chairman Hall's H.R. 5892, the Veterans Disability Benefits Claims
Modernization Act. Section 106 of that bill calls for an annual
assessment of the quality assurance program that examines data from
regional offices, the accuracy of evaluated claims, and creates
automated, categorizable data to better identify trends. My bill will
require accountability by enabling the specific identification of
potentially problematic claims raters who may knowingly manipulate
claims. Alternatively, my legislation will protect those who are doing
their jobs with integrity.
This bill is incredibly important to the veterans of Ohio; our
state was ranked dead last in average disability payments, and I cannot
stand for this. According to the IDA report, the national average
disability payment is $8,890, and Ohio's average is $7,556. I believe
we must act to restore parity to the disability payment system to
ensure each veteran receives the full benefit he or she was promised.
Senator Brown--a Member of the Senate Veterans' Affairs Committee--
agrees and has introduced an identical companion version of my bill to
the Senate.
Thank you again for your consideration of H.R. 5709. I am grateful
for the opportunity to present this important piece of legislation to
you.
______
Veterans Disability Disparity State by State Rankings \1\
------------------------------------------------------------------------
------------------------------------------------------------------------
1. New Mexico----------------------------------------------------12,395-
------------------------------------------------------------------------
2. Maine 11,734
------------------------------------------------------------------------
3. Oklahoma 11,643
------------------------------------------------------------------------
4. Arkansas 11,412
------------------------------------------------------------------------
5. West Virginia 11,348
------------------------------------------------------------------------
6. Nebraska 10,719
------------------------------------------------------------------------
7. Oregon 10,677
------------------------------------------------------------------------
8. Louisiana 9,815
------------------------------------------------------------------------
9. Vermont 9,682
------------------------------------------------------------------------
10. Kentucky 9,673
------------------------------------------------------------------------
11. North Carolina 9,549
------------------------------------------------------------------------
12. Arizona 9,502
------------------------------------------------------------------------
13. Texas 9,484
------------------------------------------------------------------------
14. Montana 9,460
------------------------------------------------------------------------
15. Mississippi 9,424
------------------------------------------------------------------------
16. Rhode Island 9,337
------------------------------------------------------------------------
17. Washington 9,156
------------------------------------------------------------------------
18. South Dakota 9,125
------------------------------------------------------------------------
19. South Carolina 9,116
------------------------------------------------------------------------
20. Tennessee 9,111
------------------------------------------------------------------------
21. Idaho 9,063
------------------------------------------------------------------------
22. Hawaii 9,047
------------------------------------------------------------------------
23. Wisconsin 8,844
------------------------------------------------------------------------
24. California 8,755
------------------------------------------------------------------------
25. Alabama 8,752
------------------------------------------------------------------------
26. Missouri 8,721
------------------------------------------------------------------------
27. Minnesota 8,709
------------------------------------------------------------------------
28. Florida 8,617
------------------------------------------------------------------------
29. Nevada 8,606
------------------------------------------------------------------------
30. Colorado 8,476
------------------------------------------------------------------------
31. Utah 8,396
------------------------------------------------------------------------
32. Wyoming 8,360
------------------------------------------------------------------------
33. Iowa 8,348
------------------------------------------------------------------------
34. Massachusetts 8,348
------------------------------------------------------------------------
35. New Hampshire 8,317
------------------------------------------------------------------------
36. Alaska 8,300
------------------------------------------------------------------------
37. New York 8,278
------------------------------------------------------------------------
38. Pennsylvania 8,270
------------------------------------------------------------------------
39. North Dakota 8,237
------------------------------------------------------------------------
40. Georgia 8,163
------------------------------------------------------------------------
41. Kansas 8,052
------------------------------------------------------------------------
42. New Jersey 8,032
------------------------------------------------------------------------
43. Michigan 7,999
------------------------------------------------------------------------
44. Illinois 7,816
------------------------------------------------------------------------
45. Connecticut 7,737
------------------------------------------------------------------------
46. Virginia 7,706
------------------------------------------------------------------------
47. Delaware 7,679
------------------------------------------------------------------------
48. Maryland 7,654
------------------------------------------------------------------------
49. Indiana 7,573
------------------------------------------------------------------------
50. Ohio 7,556
------------------------------------------------------------------------
Overall Average 8,890
------------------------------------------------------------------------
\1\ Institute for Defense Analyses Analysis of Differences in Disability
Compensation in the Department of Veterans Affairs Vol. 1: Final
Report pg. C-15 (December 2006).
______
Congress of the United States
U.S. House of Representatives
Washington, DC.
July 20, 2007
President George W. Bush
1600 Pennsylvania Ave., NW
Washington, D.C. 20502
Dear Mr. President,
In visits to Veterans County Service Offices around my district, my
staff hears time and again that veterans in Ohio are concerned about
inconsistencies in the processing of seemingly similar disability
claims. This week, the Associated Press published a story outlining the
findings of the Institute for Defense Analyses' VA-commissioned study
on veterans' annual disability pay from state to state. I am incredibly
concerned about the report's assertion that Ohio ranks dead last.
According to the report, approximately one-third of disparities may
stem from correctible factors, such as inconsistent training standards
for claims evaluators and simply placing too much power in the
subjective decisions of evaluators. While demographic factors also play
a role in overall ratings, I believe the human component can be
improved upon.
Your administration has a responsibility to ensure that the
processes the VA utilizes are of the highest industry standard, and
that those charged with overseeing those processes are doing so. In
fact, during Secretary Nicholson's 2005 confirmation hearings, he
pledged to look into the existing discrepancies. This week, as you
know, he submitted his resignation without having sufficiently acted to
standardize disability pay across state lines.
That's why I am writing to demand that the next Secretary of the
Department of Veterans Affairs make this the highest priority. The new
Secretary must ensure that veterans in Ohio and others are not being
treated unjustly and unfairly relative to the rest of the country.
Mr. President, we absolutely owe it to the veterans of Ohio to get
the bottom of why they are being shortchanged. I would appreciate
knowing your response to this matter.
Sincerely,
Zack Space
Member of Congress
Prepared Statement of Hon. Gus M. Bilirakis,
a Representative in Congress from the State of Florida
I would like to start by thanking Chairman Hall and Ranking Member
Lamborn for including my legislation, H.R. 1197, on today's hearing
agenda. The Prisoners of War Benefits Act is a bill that my father,
former Representative Mike Bilirakis, first introduced several
congresses ago. He was able to make some progress on the legislation
before he retired in 2006, and I am pleased to be continuing his
efforts on this important issue in the 110th Congress.
The Prisoners of War Benefits Act is intended to improve the
benefits currently available to former POWs. In 1981, Congress
established several service-connected presumptions for certain medical
conditions that affect former prisoners of war. However because a very
high level of research certainty (95 percent) was required before
establishing presumptive status, many other medical problems common in
POWs have been excluded.
My legislation establishes service-connected presumptions for two
additional medical conditions: Type II diabetes and osteoporosis. My
staff has worked with the American Ex-Prisoners-of-War to identify
these conditions as having strong evidence of a relationship between
the POW experience and the onset of the disease.
Congress has passed legislation giving the Department of Veterans
Affairs (VA) specific standards for determining whether the addition of
new presumptive diseases for Vietnam and Gulf War veterans is
warranted. These standards require a positive association for the
adoption of a presumptive condition. However, Congress has not
established a process for VA to add to the list of former POW
presumptive diseases established in 1981. In 2001, the VA Advisory
Committee on Former Prisoners of War recommended that the burden for
establishing POW presumptions be adjusted to match the standards used
for other beneficiary groups. Therefore, H.R. 1197 includes a provision
to establish a process by which the VA could determine future
presumptive conditions for former POWs when there is a positive
association between the experience of being a prisoner of war and the
occurrence of a disease or condition. Under my legislation, the VA
Secretary would have to review the recommendations of the Advisory
Committee on Former Prisoners of War and all other sound medical and
scientific information and analyses available when making these
determinations.
Under current law, to be eligible for disability compensation for
certain conditions presumed to be service-connected for former POWs, a
veteran must have been held in captivity for 30 or more days.
At the time when some of the original POW presumptions were
enacted, short-term prisoners of war were unusual. Prisoners of war
from more recent conflicts have been confined for shorter periods of
time. H.R. 1197 would remove the 30-day minimum requirement, making all
former POWs eligible regardless of how long they were held captive.
This provision is based on the recommendations of the VA's Advisory
Committee on Former Prisoners of War, which concluded in 2001 that this
30-day requirement should be repealed.
The 108th Congress did enact a partial repeal of the 30-day minimum
requirement as part of the Veterans Benefits Act of 2003 (Public Law
108-183). Specifically, this law eliminated the requirement that a POW
be held for 30 days or more to qualify for presumptions of service-
connection for certain disabilities. Although I am pleased that
Congress took this initial step, I believe that more can be done in
this regard and urge my colleagues to support H.R. 1197 for this
reason.
Before I close, I would like to mention how pleased I am that we
have also included H.R. 5454 on today's agenda. H.R. 5454, which I have
cosponsored, would establish a presumption of service-connection for
ALS. I have heard from some of my constituents whose loved ones suffer
from this devastating disease. They firmly believe there is a link
between their loved ones military service and their developing ALS.
In closing Mr. Chairman, I want to thank you once again for
including my bill in today's hearing. I hope that you and our other
colleagues on the Subcommittee will support H.R. 1197 and H.R. 5454. I
look forward to hearing the testimony from today's witnesses.
Prepared Statement of Hon. David Wu,
a Representative in Congress from the State of Oregon
Chairman Hall, Ranking Member Lamborn, distinguished Members of the
Subcommittee:
Thank you for the opportunity to testify today on behalf of H.R.
3008, the Rural Veterans Services Outreach and Training Act.
A few years ago, I was made aware of a problem that directly
affects millions of individuals who have defended our country. Due to
budget cuts in many areas--including my home state of Oregon--county
veterans service officers are not being funded at adequate levels.
County veterans service officers provide veterans with advice and
casework service about their VA benefits. There is a singular need for
these services in our rural communities. There are approximately 3
million veterans living in rural areas in the United States. A 2004
report published in the American Journal of Public Health indicates
that veterans in rural areas are in poorer health than their urban and
suburban counterparts. Without access to casework services, these
veterans go without all the benefits they need, deserve, and have
earned.
Some may argue that veterans in rural areas can simply drive to the
nearest VA Regional Office. But for many veterans and their caregivers,
this is impractical. According to the National Rural Health
Association, the average distance a rural veteran must travel to get
care is 63 miles. For someone who has endured the trauma of a
battlefield injury and begun the long, arduous process of
rehabilitation, this is often, simply, too much to ask.
Without access to a county veterans service officer, veterans must
rely solely on customer service representatives over the telephone or
Internet in order to access their VA services. But anyone who has ever
encountered an automated phone system knows how frustrating and
discouraging this can be. Veterans who have suffered physical,
emotional, or psychological injuries should not be forced to navigate
the VA bureaucracy alone because they do not live near a VA Regional
Office.
Our veterans deserve better, have earned better, and will get
better under this bill. County veterans service officers provide rural
communities with more than just their expertise. I believe our veterans
are served best by their fellow community members. Community members
understand a veteran's needs as they relate to his or her community,
job, and family. Armed with this information, county veterans service
officers can best advocate for the veterans they serve.
With this in mind, I introduced the Rural Veterans Services
Outreach and Training Act, which seeks to improve outreach and
assistance to veterans and their families residing in rural areas.
This bill establishes a competitive grant program at the Department
of Veterans Affairs to help eligible states hire and train county
veterans service officers for their rural communities.
The Rural Veterans Outreach and Training Act targets grant money to
the communities that need it most. This legislation requires that
grants will be used only to supplement non-Federal funding sources, not
supplant them.
We have an obligation to ensure that veterans--wherever they
reside--have access to the services they have earned and deserve. Our
men and women in uniform give so much in service to our country, and I
believe we should act accordingly to ensure they have access to local
assistance to find the help they need.
Again, I appreciate the Subcommittee's consideration of the Rural
Veterans Services Outreach and Training Act. On behalf of a grateful
nation and veterans everywhere, I look forward to working with you on
this important legislation.
Prepared Statement of Hon. Thomas H. Allen,
a Representative in Congress from the State of Maine
Thank you, Mr. Chairman, for convening this hearing on very
important veterans' disability assistance bills, including my proposal,
H.R. 5448, the ``Full Faith in Veterans Act of 2008.'' I am extremely
grateful for this opportunity to testify before the Subcommittee about
the need for my legislation, which I introduced in February of this
year.
The enormous stress of combat has long been recognized as the
source of long-term, disabling psychological and emotional illness for
many soldiers, sailors, marines and airmen. What we now know as post
traumatic stress disorder, or PTSD, is not a new phenomenon. The wars
in Iraq and Afghanistan, however, have been particularly stressful,
given the unpredictability of ambushes and IED attacks, not knowing who
is friend or foe, and repeated tours of duty. In addition, military and
medical personnel more readily recognize the symptoms of this disorder.
So it is not surprising that so many of our brave men and women return
from Iraq and Afghanistan suffering from incapacitating fears,
flashbacks, nightmares and other problems associated with their
experiences. The Department of Veterans Affairs (VA) has diagnosed PTSD
in about 67,000 Iraq and Afghanistan veterans. Because many veterans do
not seek care for these problems, the true number is undoubtedly much
higher.
PTSD has affected those who have served in our Armed Forces since
the days it was known as ``shell shock.'' Thousands of veterans from
previous conflicts continue to struggle with the long-term effects of
their service. Others have had their symptoms reemerge as a result of
the extensive news coverage of the events of September 11, 2001, and
the ongoing wars in Iraq and Afghanistan.
The goal of the Full Faith in Veterans Act is to improve diagnosis,
compensation, and treatment for veterans with PTSD.
The primary component of the legislation seeks to ensure that every
veteran whose PTSD resulted from their service receives treatment and,
if appropriate, disability compensation.
Veterans for Common Sense reviewed VA documents to determine the
number of Iraq and Afghanistan veterans diagnosed with PTSD--about
67,000. The organization also found the VA concluded that only about
half of these veterans have a service-connected disability. This raises
the question of the status for the other 30,000 or so veterans. Some
veterans may not know they can file a claim or may still have a claim
pending. But as I have learned from veterans in my district, proving
that PTSD is service-connected can be very difficult, particularly for
veterans of older conflicts. And denial of service-connection leaves
these veterans without access to VA health benefits or disability
compensation.
I crafted my bill after listening to Maine veterans victimized by
the current system. In many cases, the law appears to be stacked
against them. Instead of the support and quality healthcare they were
promised, the disabling trauma they suffered during military service
has been met with skepticism and red tape. I would like to share the
story of one of my constituents that brings these shameful
circumstances to life.
Terry Belanger is an Army veteran from Biddeford, Maine. He served
in Vietnam from 1969-1970. Terry's principal duty was to serve as a
light vehicle driver; his responsibilities included delivering and
distributing ammunition to troops surrounding Chu Lai Air Base.
Terry's time in Vietnam was harrowing. His vehicle came under enemy
fire, he reports, ``practically every night.'' Close friends were
killed in combat; another died in a stabbing over a game of cards; he
witnessed the torture of Viet Cong officers, and saw the body of the
driver of the truck ahead of his fly through a canvas top after the
vehicle struck a mine; he slept in the mud and saw body bags being
loaded on to U.S. planes. His captain was killed.
On one mission, a young Vietnamese girl suddenly appeared in front
of his truck and his vehicle ran over the little girl, probably killing
her. Because his convoy was under fire, he could not stop. Terry's
nightmares about this incident were rekindled a few years ago after he
nearly struck another child who darted in front of his car.
When he returned from Vietnam, Terry showed evidence of what
several healthcare professionals have diagnosed as severe PTSD
resulting from his service in Vietnam. It took him 6 months to want to
hold his newborn daughter, but he didn't know why. In 1989, Terry filed
a claim with the VA for service-connected PTSD. The claim was denied
due to ``lack of credible information of supporting stressors.'' Terry
would spend nearly two decades fighting his own government, a
government he had fought to defend. Time and again, the VA denied
service-connection due to lack of evidence that his condition was
linked to his military service. All the while, Terry and his family
suffered, for his government would neither pay for his medical care for
PTSD, nor provide him with disability benefits.
For 19 years, Terry tried to get the Army to search for documents
that would prove that these traumatic events had occurred. In January
1993, the National Personnel Records Center told Terry that the records
he requested ``would rarely show specific details about a unit's
activities and movements and that it was unable to perform the
extensive research requested due to staffing and budget limitations.''
Finally, in 2005, the National Archives and Records Administration
found over 4,500 pages that verified that Terry's unit was in combat
for months, just as he had claimed. This was sufficient to establish
service-connection. But because of an enormous backlog of veterans'
claims, Terry had to wait another 3 years before the VA would grant his
claim.
Last month, he finally received the VA's decision that it would
grant his claim. Terry says that it took him 3 days to stop being
angry, and he'll never understand why it took them so long to validate
his claim.
It took that long because the law is unfair. The veteran, not the
agency that possesses the records, has the burden of producing
documents that prove the trauma occurred. How was Terry Belanger, a
disabled veteran in Biddeford, Maine, supposed to find the records that
the government said it didn't have the time or money to look for? His
doctors confirmed he had PTSD. His nightmares and flashbacks referred
to his time in Vietnam. The Army trusted him when he served his
country. Why should we distrust him now, in his time of need?
Indeed, what is remarkable about Terry's case is that the records
were ever uncovered. It happened only because Terry was so persistent
and would not let his family down. He kept filing and appealing until
finally, after 16 years, someone in the National Archives found
thousands of pages that they had missed before.
Terry's story is similar to many I have heard from veterans in
Maine and, I would wager, is much like the experience veterans in each
of your districts have had. In many cases, no records are kept of
traumatic experiences in a combat theatre. As Terry had been told
earlier, military records ``would rarely show specific details about a
unit's activities and movements.'' In the case of Terry Belanger, the
records were there amid millions of others. Either way, bureaucratic
mismanagement or red tape is no excuse to deny veterans the healthcare
and compensation they have earned.
When no records can be found to substantiate the claim, a veteran
can also submit two ``buddy statements'' as evidence that their claimed
stressor actually occurred. Again, the burden of proof is placed on the
veteran to find fellow servicemembers who may remember and can
corroborate the veteran's story. This is not an easy task, particularly
when seeking individuals that the veteran may not have seen or spoken
to for decades. One can turn to the back of many veterans' magazines
and see ads submitted by veterans looking for others who can verify
their claims, like these (all from the April 2008 issue of VFW
magazine):
``173rd [Airborne] Support [Battalion], An Khe, Vietnam, 1968-
69--Seeking anyone who attend [sic] [Airborne] Jungle School
when one of the instructors was accidentally shot by one of the
other instructors next to me; anyone there when the school and
mess hall were shelled and three people were killed; cooks and
supply people; Sergeant Provost and Jimmy Gibson; anyone who
was there when the mess hall caught on fire and we put it out;
anyone who witnessed an accidental shooting on April 9, 1968,
in the bunkhouse. Need substantiation for PTSD claim.--William
E. Young, Jr.''
``222nd Personnel Services [Company], Vietnam, early 1971--
Seeking anyone in a convoy traveling between Vaung Tan and Long
Binh and saw Huey shot down. Need substantiation for PTSD
claim.--John Westbrook''
``4th [Infantry Division Artillery] Base Camp, Pleiku, Vietnam,
Sept. 1969-Nov. 1970--Seeking anyone attached to camp. Need
substantiation for PTSD claim.--Roger Carroll''
Veterans should not have to take out classified ads in order to
have their valid claims for PTSD approved by the VA.
Under my common sense bill, if a veteran is diagnosed by a
certified medical health professional as suffering from PTSD related to
the veteran's military service, the VA must accept this finding as
sufficient proof of service-connection. As with other disability
claims, the VA must resolve every reasonable doubt in favor of the
veteran. However, the VA can rebut this finding of service-connection
by clear and convincing evidence to the contrary. Thus, if contrary
evidence exists, and the VA produces it, the claim will not be allowed.
Under my bill, veterans like Terry Belanger would not have to wait
two decades for the VA to find the relevant records. The law would also
help the many veterans whose traumatic experience in the service never
made it into official records. The new standards in my bill would apply
to all veterans diagnosed with PTSD, not just those from the wars in
Iraq and Afghanistan. It would also acknowledge the inherent dangers of
military service and be applicable to all those who served our Nation
in uniform, not just those who faced combat. It also accommodates cases
of PTSD related to military sexual trauma that may not have happened in
a combat zone.
In addition to establishing a fair system for establishing service-
connection for PTSD, the bill would also ensure that the VA does a
better job at diagnosing and treating this debilitating disorder.
The bill requires that VA employees who are responsible for rating
disability compensation claims involving PTSD successfully complete a
certification program that incorporates best practices issued by the
VA's National Center on PTSD.
It directs the VA to audit the examinations that VA mental health
professionals conduct for veterans who submit claims for PTSD
disability compensation. This will help ensure these employees take
enough time to diagnose and accurately rate the severity of the
disorder.
H.R. 5448 requires that the documents mental health professionals
and raters consider when evaluating or rating PTSD must include the
veteran's records from VA Vet Centers, as well as written opinions of
any medical professional providing mental healthcare.
The bill also directs the VA to update the schedule for rating
disabilities, beginning with PTSD, traumatic brain injury, and other
disabling mental health conditions.
Finally, my measure requires the VA to implement an approach for
providing treatment for veterans with PTSD that combines treatment,
compensation, and vocational assessment.
This bill has received support from a broad array of veterans
groups, including Swords to Plowshares, Veterans for Common Sense, the
Maine Veterans Coordinating Committee and Maine's Bureau of Veterans
Services, along with the Maine departments of the American Legion,
AMVETS, the Disabled American Veterans, and the Veterans of Foreign
Wars.
For too long, America has neglected our responsibilities to the men
and women who carry the emotional scars military service sometimes
brings. They battled for us; now we must help them battle their demons,
by treating them fairly and respectfully. Terry Belanger's wife wrote,
``This wonderful man--left part of his soul in Vietnam.'' I hope and
pray that with care and support, Terry and other veterans suffering
from PTSD will be restored to full and productive lives. The Full Faith
in Veterans Act can help achieve this.
______
Swords to Plowshares
San Francisco, CA.
March 4, 2008
Hon. Thomas H. Allen
United States House of Representatives
1127 Longworth House Office Building
Washington, DC 20515-1901
Dear Representative Allen,
I write on behalf of Swords to Plowshares to thank you for
introducing the Full Faith in Veterans Act (H.R. 5448). Swords to
Plowshares is a non-profit Veterans Service Organization founded by
Vietnam Veterans in 1974 and dedicated to providing services and
support to veterans of all eras. Our legal staff have assisted
countless veterans through the complex Veterans Benefits Administration
(VB A) claims process to secure compensation for Post Traumatic Stress
Disorder (PTSD) incurred during service to our country.
H.R. 5448 addresses serious flaws in the adjudication of PTSD
claims. Under current law, veterans must have both a PTSD diagnosis and
military documentation of the traumatic stressor which caused their
PTSD, or two ``buddy statements'' describing the event. This process of
identifying two ``buddies'' and eliciting their description of painful
events causes undue trauma to all the veterans involved, and is
triggered by a failure in military documentation for which the veteran
has no control. The proposal to accept a diagnosis of PTSD by a mental
healthcare professional that establishes a logical relationship between
exposure to military stressors and current PTSD is a vast improvement
over the current process.
We also applaud the effort to establish standards in PTSD case
review through: the requirement that VBA PTSD Ratings Analysts complete
a certification program incorporating best practices issued by the VA's
National Center on PTSD; the requirement that VA audit their mental
health examinations to ensure that sufficient time is taken to
accurately diagnose and rate the severity of PTSD; and, the requirement
that the Ratings Analysts consider Vet Center records and written
opinions of other treating medical professionals in assessing PTSD
claims.
Thank you on behalf of Swords to Plowshares for your leadership in
veterans' issues and we look forward to working with you and your staff
to support the Full Faith in Veterans Act.
Sincerely,
Michael Blecker
Executive Director
______
Veterans for Common Sense
Washington, DC.
June 10, 2008
The Honorable Thomas Allen
Member of Congress
U.S. House of Representatives
1127 Longworth House Office Building
Washington, DC 20515
Dear Representative Allen:
Veterans for Common Sense (VCS) strongly supports your new bill,
``The Full Faith in Veterans Act,'' H.R. 5448. VCS asks Chairman John
Hall and the House Veterans' Affairs Committee's Subcommittee on
Disability Assistance and Memorial Affairs to favorably report the bill
at their hearing on June 12, 2008. Our VCS goal is simple: We want VA
to quickly and accurately process post traumatic stress disorder claims
so our veterans are not forced to wait months or years for disability
benefits. We thank you for your leadership on this important issue.
The Department of Veterans Affairs' (VA) disability claims process
for Iraq and Afghanistan War veterans remains broken--as shown by the
fact that VA takes, on average, more than 6 months to process an
initial claim, and VA takes nearly four more years to process a
disability claim appeal. Among the most difficult claims to process are
PTSD claims. VCS supports a presumption of a PTSD stressor based on
deployment to a war zone.
VCS remains alarmed that VA denies more than half of the PTSD
disability benefits filed by Iraq and Afghanistan war veterans. The
latest publicly available information shows that only 37,000 Iraq and
Afghanistan war veterans' VA disability claims for PTSD were approved
among the 75,000 veterans diagnosed at VA hospitals with PTSD. While
some cases may be pending or on appeal, VA's rejection rate is
suspiciously high, and the enormous disparity warrants a prompt
Congressional oversight investigation above and beyond enacting H.R.
5448.
Your bill, H.R. 5448, requires VA reports on PTSD. VCS urges
Congress to pass H.R. 1354, ``The Lane Evans Veterans Health and
Benefits Improvement Act,'' a bill that requires VA to collect data and
prepare reports about the human and financial costs of the Iraq and
Afghanistan wars. VCS believes Congress should also ask VA how many
non-Iraq and Afghanistan war veterans are diagnosed with PTSD by VA,
and how many of those have approved PTSD claims. This information
should shed more light on the issue of how VA handles PTSD healthcare
and for claims for all our Nation's veterans.
Sincerely,
Paul Sullivan
Executive Director
______
``Vietnam Veterans Seek Proof Of Stress-Inducing Events''
The Hartford Courant
By Ann Marie Somma, Courant Staff Writer
May 25, 2008
A Vietnam veteran from South Carolina is searching for three scuba
divers who helped him fish dead bodies out of Cam Rahn Bay in Vietnam
in 1967.
An air rescue medic now living in Maine is desperately seeking
anyone who remembers him killing 18 North Vietnamese during the Tet
Offensive between January and March 1968.
A Brookfield vet is hoping to find someone else who saw the
explosion of a F-100 fighter bomber aircraft at the Bien Hoa air base
in Vietnam in 1966.
Every month, the Vietnam Veterans of America's magazine website is
clogged with personal ads posted by vets around the country diagnosed
with post traumatic stress disorder. They may have survived harrowing
experiences in Vietnam, but the U.S. Department of Veterans Affairs
won't approve their claims for disability unless they can document the
exact traumatic episode that triggered the disorder.
Because the service records of so many Vietnam veterans are
incomplete and inaccurate, often their only hope is to find a fellow
soldier who will write to the VA confirming the traumatic event, known
as an in-service stressor.
The letters are known, affectionately, as buddy letters.
Robert Chechoski, a Vietnam veteran in Bridgeport who volunteers
his time to help other vets file PTSD disability claims, said the need
to produce buddy letters and to prove their trauma is hurtful for those
who still remember their bitter homecoming.
``They hid for 30 years. They tried to put Vietnam out of their
mind. A lot worked the midnight shift, because they can't deal with
people, a lot drank to forget,'' Chechoski said. ``Then something
awakens in their head, they go get counseling and help and a lot get
denied by the VA.''
Burning Embers
The veterans seeking buddy letters served in every branch of the
military. They saw soldiers die. Their lives were threatened in
ambushes, rocket attacks and shelling in villages and the jungle.
But their military records typically don't include an account of
the single traumatic event they witnessed. Their DD214s, the military
service records issued by the Department of Defense, are incomplete and
inaccurate. Some troops left Vietnam with no records at all. Those who
served in top secret government missions were, in essence, never there.
Veterans advocates say the VA's arcane standard of requiring
evidence of an in-service stressor has denied thousands of veterans
disability pay and continues at a time when the number of Vietnam-era
veterans being treated for PTSD in the VA system is increasing.
A 2007 study by Robert Rosenheck and Alan Fontana, two Yale
University researchers, found that the number of those vets being
treated for PTSD increased from 91,043 in 1997 to 189,309 in 2005. Some
experts believe the war in Iraq is triggering Vietnam memories, causing
the spike in numbers.
Before the government officially recognized PTSD in 1980, thousands
of Vietnam veterans became homeless, turned to drugs and alcohol or
died. The VA now considers PTSD a disability and uses a rating system,
from 10 to 100 percent, to determine how the illness has affected a
veteran's quality of life, relationships and ability to earn a living.
Compensation ranges from a few hundred dollars to $2,500 a month.
Chechoski, who served three tours in Vietnam and was diagnosed with
PTSD in 1996, offered an explanation of the delayed effects of the
disorder.
``Picture a Weber grill. You set a bag of charcoal on fire, then
you douse it with a 10-gallon bucket of water. You think you got that
fire out, but there is one ember that is still alive and it will ignite
sooner or later,'' Chechoski said.
Armand Flynn's ember ignited on Sept. 11, 2001, after smoldering
for more than 30 years.
The Brookfield veteran dealt with Vietnam by living a simple life.
He graduated from college, married and raised three children with a
career administering compensation benefits for major corporations. But
he drank too much. The liquor quelled his panic attacks and insomnia.
On Sept. 11, when the hijacked planes hit the World Trade Center,
Flynn flashed back to Vietnam on Oct. 6, 1966.
Flynn says he was working the flight line attached to the U.S. Air
Force 6234 Tactical Fighter Wing when a plane loaded with cannons and
air-to-air missiles caught fire on the runway at the Bien Hoa air base.
``I saw that pilot go by me minutes earlier, then his plane blew up
like an atom bomb. There was fire and noise, stuff cooking off the
plane,'' said Flynn, 63.
After the flashback he had a breakdown, and shortly after that he
sought help at the VA in West Haven. A doctor there diagnosed him with
PTSD and prescribed a cocktail of pharmaceuticals to ease his
depression, panic attacks and insomnia.
The explosion is recorded in the history of Flynn's Air Force unit.
But VA personnel trained to search military archives can't find a
record of his service in Vietnam.
Flynn says he flew from California for duty in Vietnam in August
1966 and remained there until October before moving to his permanent
assignment in Korat, Thailand. The VA says his service records place
him only in Thailand.
Last year, seeking a buddy letter to prove he was at the air base,
Flynn placed an announcement in the Vietnam Veterans of America
magazine.
Hurbert Bradshaw in California responded to Flynn's post. He says
he served with Flynn in the 6234 Tactical Fighter Wing in Vietnam and
wrote the VA that Flynn was in Vietnam with him.
``I met [Flynn] in Bien Hoa, that's why I wrote the letter,''
Bradshaw said.
The VA denied Flynn's claim, despite the letter. He is on his third
appeal.
``This has been really painful. Every time I have to appeal, I have
to reconstruct the stressors, all the things that I buried are coming
back, the memories, the nightmares,'' Flynn said.
He wonders how long he can battle the government, a quest, he said,
that has strained his 37-year marriage. He no longer works and relies
on VA health benefits. He attends a PTSD group therapy session at the
VA every Thursday.
``Is there anything else I missed, anybody I need to contact? Maybe
there is a second person? I don't know what to do,'' Flynn said.
Fixing The Process
Veterans groups have lobbied the VA to modernize the PTSD claims
process, and there are efforts in Congress to eliminate the rule that
requires proof of an in-service stressor. Now, unless a veteran
received a Combat Infantryman Badge or Purple Heart, their stressor
must be documented.
U.S. Rep. Tom Allen, D-Maine, introduced legislation in Congress
this year that would eliminate the need for veterans to prove a
stressor to receive disability compensation for PTSD.
``What these guys experienced transcends military records,'' Allen
said. ``We owe it to them. We shouldn't deny them benefits and
treatments on a technicality.''
Under Allen's Full Faith in Veterans Act of 2008, a diagnosis of
PTSD by a mental healthcare professional who establishes a logical
relationship between exposure to military stressors and current PTSD
symptoms is enough to prove that the PTSD is service connected.
At a press conference earlier this year, Allen told a group of
veterans that his father was the inspiration behind the bill. His
father volunteered for the Navy after Pearl Harbor, working control
towers on air bases in the South Pacific. The towers were bombed
nightly.
But what affected Allen's father the most were the pilots who never
returned from missions.
``My father never told me a lot about what happened to him during
the war, but I know that when he came back he had what today would be
diagnosed as PTSD,'' Allen said.
Allen said the VA system needs to be overhauled to deal with the
impending flood of PTSD claims from those serving in Iraq and
Afghanistan. A recent study conducted by the RAND Corporation found
that one in every five soldiers, or 300,000 troops of the estimated 1.7
million who have been deployed to Iraq and Afghanistan, have depression
and some sign of PTSD.
``There are no frontlines in Iraq, and we are going to have the
lingering effects of PTSD for a long time,'' Allen said.
Aaron Entrekin, a Vietnam veteran from Tennessee, said he drank
himself through two wives and countless jobs before seeking help at the
local VA hospital. Doctors there diagnosed him with PTSD in 2001, but
he hasn't found anyone to confirm his stressor.
Entrekin said he ran over a Vietnamese boy while driving a truck in
a convoy heading south from Da Nang. He doesn't remember the exact
year; 1970 or 1971, he guesses. But he'll never forget the boy's face.
``His dad was holding him in his arms. I see him every night in my
dreams and when I close my eyes,'' Entrekin said. ``He was trying to
cry, he was bleeding out of his mouth, nose and ears.''
Entrekin wanted to take the boy to the hospital.
His lieutenant ordered him to keep driving.
The U.S. Army has no record of the accident. The VA has denied his
claim three times.
His announcement in the Vietnam veterans magazine in search of a
buddy letter reads, ``They called me Slim or Hillbilly.'' Entrekin
hopes the nicknames will jar the memory of someone who served with him
in the U.S. Army's 25th Infantry Division 18th Engineer Brigade.
``If you ain't got a Purple Heart, they don't want to help you,''
he said. ``There are a lot of bad things that happened to people in
Vietnam who didn't get a Purple Heart.''
Prepared Statement of Judith A. Salerno, M.D., MS,
Executive Officer, Institute of Medicine of the National Academies
Chairman Hall asked the Institute of Medicine (IOM) of the National
Academies to provide testimony regarding several bills under
consideration by the Subcommittee. In response, we have prepared this
testimony on issues raised in these bills that are addressed by recent
IOM reports.
My name is Dr. Judith Salerno and I am the Executive Officer of the
Institute of Medicine. I serve as IOM's chief operating officer and
executive director of the Institute, and am responsible for managing
IOM's research programs. My past work includes positions at the
Department of Veterans Affairs (VA), where I directed the continuum of
VA's Geriatrics and Extended Care programs across the country. I also
previously served as Associate Chief of Staff at the VA Medical Center
in Washington, D.C., where I coordinated clinical services for older
veterans. I am honored to have had the opportunity to serve veterans
for 9 years in these capacities.
The reports I will be discussing today were written by committees
of experts convened under the auspices of the Institute of Medicine.
IOM was created in 1970 as a component of the National Academy of
Sciences, which was chartered by Congress in 1863. The National
Academies' role is to provide independent, non-partisan, evidence-based
advice to the Government and the Nation. As an independent voice, we
neither support nor oppose the legislation under discussion at today's
hearing.
I will address provisions in seven of the bills that touch on
topics covered in IOM reports.
H.R. 1197: Prisoner of War Benefits Act of 2007
H.R. 1197 addresses issues related to the establishment of
presumptions of service connection. The 2008 IOM report Improving the
Presumptive Disability Decision-Making Process for Veterans describes
the current process for making presumptive decisions for veterans who
have health conditions arising during military service and proposes a
scientific framework for making such decisions in the future. The
report was requested by the Congressionally constituted Veterans'
Disability Benefits Commission. Its findings and recommendations were
previously delivered to the Subcommittee in testimony presented on
February 26, 2008 by Jonathan M. Samet, MD, MS, and, in the interest of
brevity, won't be repeated here. H.R. 3795, 5454, 5954, and 6032--which
also deal with presumptions of service connection--are discussed below.
H.R. 3795: You Were There, You Get Care Act of 2007
H.R. 3795 would add a presumption of radiation exposure for the
purpose of service connection for veterans of the 1991 Persian Gulf War
and subsequent conflicts in that theatre. The bill also calls for an
independent study to determine diseases that may result from exposure
to depleted uranium.
In 1998, VA asked the IOM to convene a committee and to evaluate
the scientific literature regarding potential health effects from
exposure to depleted uranium. The committee's report--Gulf War and
Health: Volume 1. Depleted Uranium, Pyridostigmine Bromide, Sarin, and
Vaccines--was released in 2000. It concluded that there was inadequate
or insufficient evidence to determine whether an association exists
between uranium exposure and 14 health outcomes--lymphatic cancer, bone
cancer, nervous system disease, reproductive or developmental
dysfunction, nonmalignant respiratory disease, gastrointestinal
disease, immune-mediated disease, effects on hematologic measures,
genotoxic effects, cardiovascular effects, hepatic disease, dermal
effects, ocular effects, and musculoskeletal effects. The committee
also concluded that there was limited or suggestive evidence of no
association between uranium and clinically significant renal
dysfunction and between uranium and lung cancer at cumulative internal
doses lower than 200 mSv.
IOM is preparing an update of this report, which will include
reviews of new scientific literature available since publication of the
2000 report. This update is expected to be released in the fall of
2008. In addition, the IOM has been asked by the Department of Defense
to determine if it is feasible to conduct an epidemiological study of
veterans who were exposed to depleted uranium while on active duty. A
report addressing this question will be released later this year.
H.R. 5448: Full Faith in Veterans Act of 2008
H.R. 5448 includes provisions that instruct the VA to update the
rating criteria used to evaluate Post Traumatic Stress Disorder (PTSD)
for compensation purposes and to create a training and certification
program for the employees who perform the ratings.
In June 2007, a committee convened by the IOM at the request of the
VA completed a report entitled PTSD Compensation and Military Service.
The committee's review identified several areas where changes in
current practice might result in more consistent and accurate ratings
for disability associated with PTSD. Such ratings are performed by VA
raters using information gathered in a compensation and pension
examination and criteria set forward in the Schedule for Rating
Disabilities. Currently, the same set of criteria is used for rating
all mental disorders. They emphasize symptoms from schizophrenia, mood,
and anxiety disorders. The committee found that these criteria are at
best a crude and overly general instrument for the assessment of PTSD
disability. It recommended that new criteria be developed and applied
that specifically address PTSD symptoms and that are firmly grounded in
the standards set out in the Diagnostic and Statistical Manual of
Mental Disorders used by mental health professionals.
Determining ratings for mental disabilities in general and for PTSD
specifically is more difficult than for many other disorders because of
the inherently subjective nature of symptom reporting. In order to
promote more accurate, consistent, and uniform PTSD disability ratings,
the committee recommended that VA establish a certification program
specifically for raters who deal with PTSD claims, with the training to
support it, as well as periodic recertification. Rater certification
should foster greater confidence in ratings decisions and in the
decisionmaking process.
H.R. 5454: To amend title 38, United States Code, to establish a
presumption of service connection of amyotrophic lateral
sclerosis for purposes of the laws administered by the
Secretary of Veterans Affairs
H.R. 5454 would establish a presumption of service connection for
ALS. The available research on ALS in veterans was evaluated in an IOM
study requested by the VA that resulted in the 2006 report Amyotrophic
Lateral Sclerosis in Veterans: Review of the Scientific Literature.
Only five studies on this topic were identified. The committee charged
with performing the review found that there was limited or suggestive
evidence of an association between military service and development of
ALS. It recommended that additional studies on the relationship between
military service and ALS be conducted and that, in addition, research
was needed to explore what might be causing ALS among veterans: for
example, involvement in traumatic events, intensive physical activity,
or chemicals or other substances or activities that might be
encountered during military service.
H.R. 5709: Veterans Disability Fairness Act
H.R. 5709 would require the Secretary of the Department of Veterans
Affairs to perform annual reviews of the accuracy and consistency of
decisions on disability compensation and take those results into
account in reviewing the performance of Veterans Benefit Administration
and Board of Veterans Appeals adjudicators. The June 2007 IOM report A
21st Century System for Evaluating Veterans for Disability Benefits
found that VA's quality assurance effort has improved the accuracy of
disability benefit decisions from less than 60 percent in 2000 to 88
percent in 2006, which is commendable but still leaves considerable
room for improvement. This report was requested by the Veterans'
Disability Benefits Commission.
The 21st Century System report also found that VA's quality
assurance system did not address consistency of decisions across VA's
58 field offices. The report recommended ongoing or periodic
evaluations of inter-rater reliability as well as the accuracy and
validity of ratings across field offices and impairment categories
(Recommendation 5-4). The report similarly recommended periodic
assessment of the inter-rater reliability of the disability
examinations performed by the Veterans Health Administration, which are
a key input to the disability determination process (Recommendation 5-
3). It should be noted, however, that the report stated that
variability cannot be totally eliminated in evaluating most disabling
conditions, because there will always be conditions with significant
subjective elements such as mental disorders and back and joint pain.
The report, therefore, emphasized using quality assurance results to
improve the controllable elements of the decisions making system, for
example, by revising guidelines, training, and/or rater qualifications
and performance standards. It should also be noted that the main
finding of the 21st Century System report was that the VA Schedule for
Rating Disabilities is badly out of date for certain body systems such
as musculoskeletal disorders, thereby hindering raters from providing
accurate assessments of veterans' disabilities. The report recommended
that VA immediately update the Rating Schedule using current medical
knowledge, which should itself improve the accuracy and consistency of
rating decisions.
H.R. 5954: To amend title 38, United States Code, to provide veterans
for presumptions of service connection for purposes of benefits
under laws administered by Secretary of Veterans Affairs for
diseases associated with service in the Armed Forces and
exposure to biological, chemical, or other toxic agents as part
of Project 112, and for other purposes.
H.R. 5954 establishes a mechanism for determining presumptive
service connections for diseases that could be related to participation
in Project 112, which included an effort referred to as Project SHAD.
The 2007 IOM report Long-Term Health Effects of Participation in
Project SHAD (Shipboard Hazard and Defense), which was requested by the
VA, found no clear evidence that specific long-term health effects were
associated with participation in Project SHAD. The IOM study compared
the health of veterans who participated in SHAD with the health of a
similar group of veterans who did not participate. Although more SHAD
veterans have died of heart disease, overall mortality rates among both
groups of veterans were similar. Moreover, the differences in the rates
of medical symptoms and conditions experienced by each group were
generally slight, and the committee responsible for the report found no
consistent, specific patterns of ill health among SHAD veterans.
However, because of limitations in the study response rates and the
size of the study, the report's findings should not be viewed as clear
evidence that there are no possible long-term health effects related to
SHAD involvement. Additionally, there have been very few hypotheses
about specific health problems that could be related to the materials
used in the SHAD tests to serve as a starting point for further
investigation.
H.R. 6032: To amend title 38, United States Code, to direct the
Secretary of Veterans Affairs to provide wartime disability
compensation for certain veterans with Parkinson's disease.
The IOM has convened several committees under a mandate contained
in the Agent Orange Act 1991 (Public Law 102-4), charged with
evaluating the scientific evidence regarding associations between
diseases and exposure to dioxin and other chemical compounds in
herbicides applied during the Vietnam War. These committees have
produced a series of reports on the topic, the most recent of which is
Veterans and Agent Orange: Update 2006. Their work is supported under a
contract with the VA.
One health outcome examined in these reports is Parkinson's
disease. The committee responsible for Update 2006 found that the
evidence is inadequate or insufficient to determine whether there is or
is not an association between Parkinson's disease and exposure to the
herbicides used in Vietnam and their contaminants. Several studies have
reported associations of Parkinson's disease with exposure to
``pesticides'' or to ``herbicides'' in general, but none yet reviewed
have established a relationship with the specific herbicides sprayed in
during the war. This condition continues to be of great interest to the
committee and the latest research on the topic will be a subject of the
next update, which will be released in 2009.
The reports discussed here addressed a number of other topics
related to veterans health and disability policy and also reached a
series of other recommendations regarding these topics. The National
Academies would be pleased to provide Members of the Subcommittee with
hard copies of these reports upon request. The reports are also freely
accessible online at the URLs listed in the references below.
Thank you for the opportunity to present this testimony before the
Subcommittee today. I would be happy to address any questions you may
have.
Institute of Medicine reports cited in this testimony
A 21st century System for Evaluating Veterans for Disability
Benefits. (2007). http://www.nap.edu/catalog.php?record_id=11885.
Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific
Literature. (2006). http://www.nap.edu/catalog.php?record_id=11757.
Gulf War and Health: Volume 1. Depleted Uranium, Pyridostigmine
Bromide, Sarin, and Vaccines (2000). http://www.nap.edu/
catalog.php?record_id=9953.
Improving the Presumptive Disability Decision-Making Process for
Veterans. (2008). http://www.nap.edu/catalog.php?record_id=11908.
Long-Term Health Effects of Participation in Project SHAD
(Shipboard Hazard and Defense). (2007). http://www.nap.edu/
catalog.php?record_id=11900.
PTSD Compensation and Military Service. (2007). http://www.nap.edu/
catalog.php?record_id=11870.
Veterans and Agent Orange: Update 2006. (2007). http://www.nap.edu/
catalog.php?record_id=11906.
Prepared Statement of Sidath Viranga Panangala,
Analyst in Veterans Policy, Congressional Research Service
Library of Congress
Introduction
Chairman Hall, Ranking Member Lamborn, and Members of the
Committee, my name is Sidath Panangala, from the Congressional Research
Service (CRS). I am accompanied today by Christine Scott, Specialist in
Social Policy, and Douglas Weimer, Legislative Attorney, also from CRS.
We are honored to appear before the Committee. As requested by the
Committee, my testimony will highlight major legislative milestones in
the establishment of presumptions of service-connection for veterans'
benefits. This is not an exhaustive list of legislation and regulations
relating to the establishment of presumptions of service-connection.\1\
CRS takes no position on any legislation that is under discussion
today.
---------------------------------------------------------------------------
\1\ For a detailed legislative and regulatory history of
presumptions see the following: National Academy of Sciences, Institute
of Medicine (IOM), Improving the Presumptive Disability Decision-Making
Process for Veterans (2008); Zeglin, Donald, ``Presumptions of Service
Connection'', paper prepared for the Veterans' Disability Benefits
Commission (VDBC) (March, 2006); and Department of Veterans Affairs
(VA), ``Analysis of Presumptions of Service Connection,'' a report to
Senate Committee on Veterans' Affairs, December 23, 1993.
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Compensation for Service-Connected Disabilities
In general, a veteran is entitled to compensation for disabilities
incurred in or aggravated during active military, naval or air
service.\2\ Currently, there are five ways to establish that a
disability is service-connected:
---------------------------------------------------------------------------
\2\ 38 U.S.C. Sec. 1110.
1. Through direct service-connection--that is, the facts, shown by
evidence, establish that a particular injury or disease resulting in a
disability was incurred while in service in the Armed Forces (38 CFR
---------------------------------------------------------------------------
Sec. 3.303);
2. Through aggravation during service--that is, a preexisting
injury or disease will be considered to have been aggravated while in
service in the Armed Forces (38 CFR Sec. 3.306);
3. Through proximity--that is, a disability, which is proximately
due to, or the result of a service-connected disease or injury which is
considered to be service-connected (38 CFR Sec. 3.310). For example, a
veteran developing cardiovascular disease due to a service-connected
amputation of a lower limb.
4. Through a finding, the disability was caused by medical care or
vocational rehabilitation provided by the Department of Veterans
Affairs (VA)--Disabilities caused by VA provided medical care or
vocational rehabilitation are treated as if they are service-connected
(38 U.S.C. Sec. 1151).
5. Through the application of statutory presumptions--that is
certain diseases as established by law or regulation are considered to
have been incurred in or aggravated by service in the Armed Forces even
though there is no evidence of such disease during the period of
service (38 CFR Sec. 3.307);
Today I will discuss the history of this fifth mechanism, the
establishment of statutory presumptions.
What is a Presumption?
In the context of VA claims adjudication, a presumption could be
seen as a procedure to relieve veterans of the burden to prove that a
disability or illness was caused by a specific exposure that occurred
during service in the Armed Forces. In other words, a presumption
shifts the burden of proof concerning whether a disease or disability
was caused or aggravated due to service, from the veteran to the VA.
Often presumptions are applied to chronic diseases or illnesses that
manifest after a period of time (sometimes many years) following
service, and that may also occur in individuals who have never served.
According to the VA's Analysis of Presumptions of Service Connection:
Generally, a legal presumption is a procedural device that
shifts the burden of proof by attaching certain consequences to
the establishment of certain basic evidentiary facts. When the
party invoking a presumption establishes the basic fact(s)
giving rise to the presumption, the burden of proof shifts to
the other party to prove nonexistence of the presumed fact. A
presumption, as used in the law of evidence, is a direction
that if fact A (e.g., manifestation within the specified period
of a disease for which a presumption of service connection is
available) is established, then fact B (service connection) may
be taken as established, even where there is no specific
evidence proving fact B (i.e., no medical evidence of a
connection between the veteran's disease and the veteran's
military service).\3\
---------------------------------------------------------------------------
\3\ Department of Veterans Affairs (VA), ``Analysis of Presumptions
of Service Connection'' a report to the Senate Committee on Veterans'
Affairs, December 23, 1993, p. i.
---------------------------------------------------------------------------
Legislative History of Presumptions
The legislative history of veterans' disease presumptions dates
back to 1921 when Congress, to ease the disability decisionmaking
process in VA disability compensation adjudications, used its authority
to establish service-connection on a presumptive basis. Given below is
a synopsis of major legislation.
1920s-1940s
The first legislation that specifically established a presumption
of service-connection was the amendment of August 9, 1921 (P.L. 67-47)
to the War Risk Insurance Act (P.L. 63-193). This Act, among other
things, established presumptions of service-connection for active
pulmonary tuberculosis and neuropsychiatric disease (later known as
psychosis) occurring within 2 years of separation from active duty
military service. Prior to the passage of P.L. 67-47, disability
compensation for World War I veterans was payable only for a disability
directly related to military service. Broadly, the intent of this
liberalization legislation was that ``as the period beginning with the
end of the war lengthened it became increasingly difficult to establish
service-connection for some ailments particularly tuberculosis and
neuropsychiatric disease.'' \4\ The amendments to the War Risk
Insurance Act also gave the then Veterans Bureau, authority to
establish rules and regulations to carry out provisions in the Act.
This allowed the agency to promulgate regulations establishing
presumption of service-connection for certain diseases. As stated in
VA's Analysis of Presumptions of Service Connection:
---------------------------------------------------------------------------
\4\ U.S. Congress, House Committee on Veterans Affairs, The
Provision of Federal Benefits for Veterans, An Historical Analysis of
Major Veterans Legislation, 1862-1954, committee print, 84th Cong., 1st
sess., House Committee Print No 171, December 28, 1955 (Washington:
GPO, 1955), p. 21.
Regulation No. 11 provided that chronic constitutional
diseases, other than active pulmonary tuberculosis or
neuropsychiatric disease, becoming manifest within 1 year
following the date of separation from active service would be
considered as incurred in service or aggravated by service
unless there were affirmative evidence to the contrary or
evidence establishing that some intercurrent disease or injury
which is a recognized cause of the disorder was suffered
between the date of separation from service and the onset of
the chronic disease.\5\
---------------------------------------------------------------------------
\5\ Department of Veterans Affairs (VA), ``Analysis of Presumptions
of Service Connection,'' a report to Senate Committee on Veterans'
Affairs, December 23, 1993, p. 10.
The next major piece of legislation that established presumptions
of service-connection was the World War Veterans Act of 1924 (P.L. 68-
242) enacted on June 7, 1924. This Act made important changes to
existing laws on presumptions related to tuberculosis and mental
illness. Among other things, this Act added the following three
diseases to the list of presumptive diseases: dysentery (amebic)
(tropical disease added as chronic disease); paralysis agitans (now
known as Parkinson's disease); encephalitis lethargica. Furthermore,
this Act removed requirements that a veteran must show diagnosis by a
medical examination conducted by a medical officer of the then Veterans
Bureau or duly qualified physician within the presumptive period.
``This provision alone brought within the purview of the legislation
thousands of veterans who [until then] had been unable to connect their
disabilities with the service so as to be eligible for compensation and
[medical care].'' \6\
---------------------------------------------------------------------------
\6\ U.S. Congress, House Committee on Veterans Affairs, The
Provision of Federal Benefits for Veterans, An Historical Analysis of
Major Veterans Legislation, 1862-1954, Committee print, 84th Cong., 1st
sess., House Committee Print No. 171, December 28, 1955 (Washington:
GPO, 1955), p. 23.
---------------------------------------------------------------------------
Between the passage of the World War Veterans Act of 1924 and P.L.
80-748 several additions were made to the list of presumptive diseases
through regulation and executive order. More significantly, the chronic
disease category was significantly expanded through the enactment of
P.L. 80-748 on June 24, 1948.
1950s-1980s
With the passage of the Veterans Benefits Act of 1957 (P.L. 85-56),
Congress codified the existing list of presumptions and expanded this
list by incorporating various presumptions of chronic diseases and
disease categories that had been established by regulation and were in
effect at that time. By the time P.L. 85-56 was enacted on June 17,
1957, there were forty chronic diseases or disease categories and
seventeen tropical diseases that were presumptively service-connected.
The sixties did not see any significant legislative or regulatory
changes affecting presumptions of service-connection.
The next major legislative change occurred with the enactment of
P.L. 91-376 in August 1970. This law established a presumption of
service-connection for seven categories of diseases and conditions for
any veteran held as a Prisoner of War (POW) in World War II, the Korean
conflict, or the Vietnam War, and who suffered from dietary
deficiencies, forced labor, or inhumane treatment in violation of the
terms of the Geneva Conventions of July 27, 1929, and August 12, 1949.
In August 1981, Congress passed the Former Prisoner of War Benefits
Act of 1981 (P.L. 97-37). This Act, among other things, modified the
list of statutory presumptions associated with POW status and also
changed the presumptive period for eligibility. The Veterans'
Compensation and Program Improvements Amendments of 1984 (P.L. 98-223);
the Veterans' Benefits Improvements and Healthcare Authorization Act of
1986 (P.L. 99-576); and the Veterans' Benefits and Services Act of 1988
(P.L. 100-322) expanded the list of diseases in former POWs for which a
presumption of service-connection was made. Prior to the passage of the
Veterans' Healthcare, Training and Small Business Loan Act of 1981
(P.L. 97-72), veterans who complained of Agent Orange-related illnesses
were at the lowest priority for treatment at VA medical facilities
because these conditions were not considered service-connected. P.L.
97-72 elevated Vietnam veterans' priority status for healthcare at VA
facilities by recognizing a veteran's own report of exposure as
sufficient proof to receive medical care unless there was evidence to
the contrary.
After taking into consideration the ``apprehension and concern
among some Vietnam veterans and their families . . . to the alleged
ill-health effects among some Vietnam veterans . . . to exposure to the
dioxin in Agent Orange,'' \7\ Congress passed the Veterans' Dioxin and
Radiation Exposure Compensation Standards Act of 1984 (P.L. 98-542).
The Act required the VA to develop regulations for disability
compensation for Vietnam veterans exposed to Agent Orange.\8\ Veterans
seeking compensation for a condition they thought to be related to
herbicide exposure had to provide proof of a service-connection that
established the link between the exposure and the disease onset. P.L.
98-542 also authorized disability compensation payments to Vietnam
veterans for the skin condition chloracne, which is associated with
herbicide exposure. This law also established a program to provide
disability compensation to radiation-exposed veterans who participated
in the U.S. atmospheric atomic tests or in the U.S. occupation of
Hiroshima and Nagasaki, Japan.
---------------------------------------------------------------------------
\7\ U.S. Congress, House Committee on Veterans' Affairs, Veterans'
Dioxin and Radiation Exposure Compensation Standards Act. Report to
Accompany H.R. 1961, 98th Congress, 2nd sess., H.Rept. 98-592.
\8\ Between 1962 and 1971, the U.S. Air Force sprayed approximately
107 million pounds of herbicides in South Vietnam for the purpose of
defoliation and crop destruction. The herbicides sprayed during the
Vietnam era contained mixtures of 2,4-dichlorophenoxyacetic acid (2,4-
D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and
cacodylic acid. The most extensively used defoliant compound, a 50:50
combination of 2,4-D and 2,4,5-T, came to be known as ``Agent Orange''
because of the orange-colored band placed on each chemical storage
container. For further information see CRS Report, RL34370, Veterans
Affairs: Healthcare and Benefits for Veterans Exposed to Agent Orange,
by Sidath Viranga Panangala.
---------------------------------------------------------------------------
In response to atomic veterans' complaints about the difficulty of
getting compensation under P.L. 98-542, Congress in 1988 enacted the
Radiation-Exposed Veterans' Compensation Act (P.L. 100-321) which
established a presumption of a service connection for 13 specified
types of cancer. That list was subsequently expanded, first by
legislation, later through VA administrative action, to 21 cancers.\9\
---------------------------------------------------------------------------
\9\ For further information see CRS Report, RL33927, Selected
Federal Compensation Programs for Physical Injury or Death, by Sarah A.
Lister and C. Stephen Redhead.
---------------------------------------------------------------------------
1990s-2000
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. Under the Agent Orange Act, veterans seeking
disability compensation for diseases they thought to be associated with
herbicides no longer were required to provide proof of exposure. P.L.
102-4 authorized the VA to contract with the Institute of Medicine
(IOM) of the National Academy of Sciences (NAS) to conduct a scientific
review of the evidence linking certain medical conditions to herbicide
exposure. For the first time the Act established a new process
establishing presumptive service-connection for illnesses related to
herbicide exposure. According to an article published in the Journal of
Law and Policy: ``The [IOM] process has become an essential step in
ensuring that new service-connection presumptions command scientific
credibility.'' \10\
---------------------------------------------------------------------------
\10\ Brown, Mark, ``The Role of Science in Department of Veterans
Affairs Disability Compensation Policies for Environmental and
Occupational Illnesses and Injuries,'' Journal of Law and Policy, vol
13, (2005).
---------------------------------------------------------------------------
The Veterans' Radiation Exposure Amendments of 1992 (P.L. 102-578)
amended P.L. 100-321 by adding two more cancers to the presumptive
list. This was based on the ``Biological Effects of Ionizing Radiation
V'' (BEIR V) report by the National Academy of Sciences (NAS).\11\ This
law also repealed the disability compensation requirement that diseases
suffered by radiation-exposed veterans must be manifested within 40
years of exposure.
---------------------------------------------------------------------------
\11\ Committee on the Biological Effects of Ionizing Radiation
(BEIR), National Research Council, is part of the National Academy of
Sciences.
---------------------------------------------------------------------------
In November 1994, Congress enacted the Persian Gulf War Veterans'
Benefits Act (P.L. 103-446), allowing the VA to pay compensation
benefits to veterans for Gulf War-related disabilities caused by
undiagnosed illnesses. This Act also codified VA's regulatory
presumptions based on exposure to herbicides for these types of cancer:
Hodgkin's disease, multiple myeloma, and respiratory cancers; and
porphyria cutanea tarda, a metabolic disease (must occur within 1 year
of exposure).
In 1998, Congress enacted the Persian Gulf War Veterans Act of 1998
(P.L. 105-277), and the Veterans Programs Enhancement Act 1998, (P.L.
105-368). Similar to the Agent Orange presumptive program, these laws
mandated regular and thorough reviews of the scientific and medical
literature relevant to the health of Gulf War veterans by the IOM.
The Veterans Education and Benefits Expansion Act of 2001 (P.L.
107-103) expanded the definition of ``qualifying chronic disability''
to include a ``medically unexplained chronic multisymptom illness (such
as chronic fatigue syndrome, fibromyalgia, and irritable bowel
syndrome) that is defined by a cluster of signs or symptoms.'' \12\
Further more, the Veterans Benefits Act of 2003 (P.L. 108-183) provided
a presumption of service-connection for cold weather injuries,
traumatic arthritis, and certain psychiatric disabilities in former
POWs, without regard to length of internment.
---------------------------------------------------------------------------
\12\ Subsection 202 (a) of the Veterans Education and Benefits
Expansion Act of 2001 (P.L. 107-103), December 27, 2001.
---------------------------------------------------------------------------
With passage of the National Defense Authorization Act, FY2008
(P.L. 110-181), Congress established a presumption of service-
connection for purposes of VA medical care for any veteran of the
Persian Gulf War who develops an active mental illness (other than
psychosis) if such veteran develops such disability: (1) within 2 years
after discharge or release from the active military, naval, or air
service; and (2) before the end of the 2-year period beginning on the
last day of the Persian Gulf War.\13\
---------------------------------------------------------------------------
\13\ The term ``Persian Gulf War'' means the period beginning on
August 2, 1990, and ending on the date thereafter prescribed by
Presidential proclamation or by law (38 U.S.C. Sec. 101 (33)).
---------------------------------------------------------------------------
Institute of Medicine Study on Presumptive Disability Decision-Making
Since an ``increasing proportion of service-connected disability
compensation is paid through a presumptive decisionmaking process,''
\14\ the Veterans' Disability Benefits Commission (VDBC) in 2006,
requested the IOM, to provide a framework on how future presumptions
should be made based on scientific principles.\15\ In 2007, the IOM
made several recommendations--which the VDBC generally endorsed--which
would, among other things, create an advisory Committee and a
scientific review board. The advisory Committee ``would consider, and
give priority to the exposures and health conditions proposed for
possible presumptive evaluation'' while the ``science review board, an
independent body, would evaluate the strength of the evidence (based on
causation) that links a health condition to a military exposure.'' \16\
Next, the independent science review board's report and recommendations
would go to VA for its consideration and implementation.\17\
---------------------------------------------------------------------------
\14\ Honoring the Call to Duty: Veterans' Disability Benefits in
the 21st Century, Report of the Veterans Disability Benefits
Commission, (October 2007), p. 153. The Commission was established by
the National Defense Authorization Act for FY2004 (P.L. 108-136).
\15\ Ibid. p. 17.
\16\ National Academy of Sciences, the Institute of Medicine (IOM),
Improving the Presumptive Disability Decision-Making Process for
Veterans (2008), p. 3.
\17\ Ibid. p.18.
---------------------------------------------------------------------------
Conclusion
Since 1921, Congress has established numerous presumptions of
service connection for a variety of health conditions affecting
veterans. In establishing these presumptions, Congress and others have
sought to balance the dual obligations of the VA, to provide care for
veterans who were harmed by their service, and to do so in a manner
that is equitable, scientifically sound, and accountable.
Prepared Statement of Les Jackson,
Executive Director, American Ex-Prisoners of War
Chairman Hall, Distinguished Members of the Subcommittee on
Disability Assistance & Memorial Affairs, and Guests. Thank you for
inviting us to participate in your legislative hearings on several
bills now pending in the House Committee on Veterans Affairs. We will
confine our remarks to H.R. 1197 Improved Veterans' Benefits for Former
Prisoners of War.
Ninety nine percent of former Prisoners of War are from WWII and
Korea and are now living in their sunset years. We are grateful that
Congress has through the years provided benefits for former Prisoners
of War where it has been determined that the causal effect of an injury
or illness is from the captive experience.
For more than 50 years the National Academy of Sciences has been
conducting scientific research to identify medical conditions that,
beyond any doubt, are the direct consequences of the brutal conditions
of captivity.
There are two medical conditions cited that still deserve
presumptive status. These are osteoporosis and diabetes. Osteoporosis
is bone loss attributed to starvation during captivity. Similarly,
diabetes is the result of prolonged stress and permanent damage to the
body's basic defense system as a result of months and years of grossly
inadequate diet as a Prisoner of War.
These two proposed presumptives have again been introduced by
Representative Gus Bilirakis (R-FL). We are deeply thankful to him and
strongly urge your committee's support by codifying these two
conditions into law without further delay.
Also, very important to former Prisoners of War and their survivors
is H.R. 156, to amend 38, U.S. Code, to provide for the payment of DIC
to survivors of former POWs who died before September 30, 1999, with
the same eligibility as applied to payment of DIC to Survivors of
former POWs who die after that date. This will be of great financial
aid to the surviving spouses of POWs. Thank you.
Prepared Statement of Steve Smithson,
Deputy Director, Veterans Affairs and Rehabilitation Commission,
American Legion
Mr. Chairman and Members of the Subcommittee:
Thank you for this opportunity to present The American Legion's
views on the bills being considered by the Subcommittee today. The
American Legion commends the Subcommittee for holding this hearing.
H.R. 1197, Prisoner of War Benefits Act of 2007
The purpose of this bill is to amend title 38, United States Code,
(U.S.C.) to provide improved benefits for veterans who are former
prisoners of war.
Specifically, this bill would repeal the current requirement in
title 38 U.S.C. that an individual had to have been detained or
interned for a period of not less than 30 days in order to be entitled
to presumptive service connection for certain Prisoner of War (POW)
diseases. It would also expand the list of POW diseases presumed to be
service-connected, currently set forth in title 38, U.S.C., section
1112(b), to include diabetes type 2 and osteoporosis. The legislation
would also specifically authorize the Secretary of Veterans Affairs to
create regulations adding or deleting diseases enumerated in section
1112(b), on the basis of sound medical and scientific evidence, to
include recommendations from The Department of Veterans Affairs' (VA's)
Advisory Committee on Former Prisoners of War.
The issue of the welfare and well-being of those veterans who have
endured the hardship and trauma of being held as a POW has long been
one of the major concerns of The American Legion. To ensure that the
government of the United States fulfills its obligation to these brave
men and women, The American Legion has actively supported improvements
in benefits provided to these individuals and their survivors. We are
pleased to support the addition of the two conditions, specified in
this bill, to the list of those currently presumed to be service-
connected. It is hoped this legislation will provide the impetus for
continuing action to further broaden the list of presumptive diseases
and disabilities, from which former POWs are known to suffer. Toward
this end, we are encouraged that the bill recognizes and emphasizes the
important role played by VA's Advisory Committee on Former Prisoners of
War. This group of esteemed individuals, many of who, are themselves
former POWs, provide the necessary mechanism and forum to evaluate
scientific and medical studies on former POWs to make appropriate
recommendations to the Secretary regarding needed changes in VA's
outreach, benefits, and medical care program for this community of
veterans.
Additionally, The American Legion has long supported the
elimination of the arbitrary 30-day requirement for internment. Studies
have shown there can be long-lasting, adverse health effects resulting
from even a relatively short period of confinement as a prisoner of
war. Such findings are especially important considering the nature of
today's warfare and the rather short period of confinement most
American POWs have faced during the post-Vietnam era.
This legislation represents a solid step toward ensuring former
POWs receive the compensation and medical care to which they are
clearly entitled. However, in addition to those diseases that would be
presumed service-connected, The American Legion recommends that the
list also include chronic pulmonary disease, where there is a history
of forced labor in mines during captivity, and generalized
osteoarthritis, as differentiated from the currently listed disability
of post traumatic osteoarthritis.
H.R. 3008, Rural Veterans Services Outreach and Training Act
The purpose of this bill is to amend title 38, U.S.C., to improve
services for veterans residing in rural areas. Specifically, this bill
would establish a competitive grant program to provide financial
assistance to state entities for veterans' affairs for the training of
rural county veteran service officers in order to improve outreach and
assistance to veterans, their spouses, children and parents, who may be
eligible to receive benefits under the laws administered by the
Secretary of Veterans Affairs, and to ensure that such individuals are
fully informed about, and assisted in applying for, any benefits and
programs under such laws.
Providing proper outreach and assistance to the Nation's veterans,
has been, and will continue to be, a top priority of The American
Legion. Although we do not have an official position, in the form of a
resolution adopted by our membership, specifically addressing a grant
program for such purposes, as proposed in this legislation, we would
not oppose the Committee's favorable consideration of this bill.
H.R. 3070, Disabled Veterans' Caregiver Compensation Act
The purpose of this bill is to amend title 38, U.S.C., to authorize
additional compensation to be paid to certain veterans in receipt of
compensation for a service-connected disability rated totally disabling
for whom a family member dependent on the veteran for support provides
care.
As written, this bill would provide additional compensation in the
amount of $234 per month to totally disabled service-connected veterans
in need of regular aid and attendance only where the veteran is being
taken care of by an adult family member who is dependent upon the
veteran for support. It should be noted that veterans who are
permanently disabled and in need of aid and attendance already receive
an additional $618 per month (SMC L pays $3,145) over the 100-percent
rate ($2,527). Therefore, this bill will raise the monthly benefit
amount for this subset of veterans from $3,145 to $3,379.
The additional money paid to veterans, who need aid and attendance,
is intended, in part, to help veterans who require aid and attendance
to hire people who could provide care. Obviously, this bill
contemplates that the veteran could use the additional $234 to
compensate the adult family member who is taking care of the veteran.
It is unclear why this additional amount would be provided as separate
from the regular aid and attendance benefit because the purpose of the
aid and attendance benefit is to pay for such care as addressed in this
bill. It is also unclear as to how VA will determine who qualifies as a
family member dependent on the veteran for support. This being the
case, The American Legion would support an increase in the overall aid
and attendance benefit rather than a separate payment as set forth in
this bill.
H.R. 3795, You Were There, You Get Care Act of 2007
The purpose of this bill is to amend title 38, U.S.C., to provide
that veterans of service in the 1991 Persian Gulf War and subsequent
conflicts shall be considered to be radiation-exposed veterans for the
purposes of the service connection of certain diseases and
disabilities, and for other purposes.
Depleted Uranium (DU) munitions were widely used in the Southwest
Asia theater of operations during the 1991 Gulf War and have been used
extensively in military operations since then, including the current
conflicts in Iraq and Afghanistan. As a result, there have been
thousands of military personnel exposed to DU fallout from these
munitions, including some with retained shell fragments due to
``friendly fire'' incidents. The American Legion supports the intent of
this bill. The American Legion recognizes the potentially harmful
effect of DU exposure. This legislation would provide for the
presumption of service connection for diseases associated with such
exposure for those suffering from such a disease who served in the 1991
Gulf War and any subsequent conflict where DU munitions were used. This
legislation would also include service in the theater of operations of
that war or conflict or involved the clean-up or servicing of vehicles
or equipment that had been used in such a theater of operations.
H.R. 4274, Gold Star Parents Annuity Act of 2007
The purpose of this bill is to amend title 38, U.S.C., to provide
for the payment of a monthly stipend to the surviving parents (known as
Gold Star parents) of members of the Armed Forces who die during a
period of war.
The American Legion does not have a position on this legislation.
H.R. 5155, Combat Veterans Debt Elimination Act of 2008
The purpose of this bill is to amend title 38, U.S.C., to prohibit
the Secretary of Veterans Affairs from collecting certain debts to the
United States in the case of veterans who die as a result of a service-
connected disability incurred or aggravated on active duty in a combat
zone, and for other purposes.
Although we agree with the intent of this bill, the legislation
contains limitations and restrictions we do not support. The American
Legion supports prohibiting the collection of debts in the case of any
veteran who dies as a result of a service-connected disability, not
just those who die of a service-connected disability incurred or
aggravated while serving in a theater of combat operations or in combat
against a hostile force during a period of hostilities.
A veteran's death due to a service-connected disability not related
to combat is no less tragic for the veteran's family than a death due
to a combat-related service-connected condition and we see no
justification in making such a distinction. This bill also leaves it up
to the discretion of the VA Secretary to determine if termination of
collection of the debt is in the best interest of the United States and
does not set forth any standards or criteria that must be met in
determining whether or not termination of collection is in the best
interest of the United States.
Unfortunately, such vagueness will likely result in a restrictive
interpretation which will, in turn, limit the beneficial impact that
was obviously intended. The American Legion also has concerns over the
exclusion of debts involving housing and small business benefit
programs from the prohibition of collection.
H.R. 5448, Full Faith in Veterans Act of 2008
The purpose of this bill is to amend title 38, U.S.C., to improve
the disability compensation evaluation procedure of the Secretary of
Veterans Affairs for veterans with post traumatic stress disorder, to
improve the diagnosis and treatment of post traumatic stress disorder
by the VA Secretary, and for other purposes.
The American Legion supports the intent of this bill to correct
current deficiencies in the service connection and evaluation of post
traumatic stress disorder.
H.R. 5454
The purpose of this bill is to amend title 38, U.S.C., to establish
a presumption of service connection for amyotrophic lateral sclerosis
(ALS) for the purpose of the laws administered by the VA Secretary.
ALS is an insidious disease involving degeneration of the nerve
cells in the brain, the brain stem, or spinal cord. ALS is
characterized by atrophy and almost always fibrillation of the muscular
system of the body. Although the disease was first identified in 1869,
we still do not know what causes it or how it can be prevented,
effectively treated or cured. ALS in its primary stage is difficult, if
not impossible, to diagnose since in this stage the condition may
appear to be dormant with little or no progression of symptoms for many
years, thus leading the individual and his or her doctor to believe the
condition has become arrested and nothing more is done to establish its
diagnostic entity.
Specifically, this bill, if enacted, would eliminate the 1-year
delimiting period currently in place for the presumptive service
connection of ALS, allowing for the presumptive service connection of
ALS for veterans diagnosed with the disease anytime after military
service. The American Legion fully supports this legislation. In fact,
we have formally voiced our concerns over the inadequacy of the current
1 year presumptive period for many years.
The timeliness and appropriateness of this bill is further
supported by research in the last several years that has indicated that
those who have served in the military are at greater risk of developing
ALS than those who never served in the military. Moreover, the
Institute of Medicine, in a November 2006 report entitled Amyotrophic
Lateral Sclerosis in Veterans: Review of the Scientific Literature,
concluded that current scientific evidence supports the increased risk
of ALS in military veterans.
H.R. 5709, Veterans Disability Fairness Act
The purpose of this bill is to amend title 38, U.S.C., to require
the VA Secretary to carry out quality assurance activities with respect
to the administration of disability compensation, and for other
purposes.
The American Legion supports this bill.
H.R. 5954
The purpose of this bill is to amend title 38, U.S.C., to provide
veterans for the presumptions of service connection for purposes of
benefits under the laws administered by the VA Secretary for diseases
associated with service in the Armed Forces and exposure to biological,
chemical, or other toxic agents as part of Project 112, and for other
purposes.
The American Legion fully supports this bill as it would put in
place the process for establishing presumption of service connection
for diseases that have been scientifically associated with exposure to
the various agents and chemicals used in Project 112.
H.R. 5985, Compensation for Combat Veterans Act
The purpose of this bill is to amend title 38, U.S.C., to clarify
the service treatable as service engaged in combat with the enemy for
utilization of non-official evidence for proof of service connection in
a combat-related disease or injury.
A bill with a similar intent (H.R. 5892) was recently passed by
this Committee. Both Title I of H.R. 5892 and this bill seek to define
``engaged in combat with the enemy,'' under title 38 U.S.C. section
1154(b), in a manner that it is consistent with the realities of combat
in today's world.
The American Legion supports the intent of these bills. Unless a
veteran was wounded or received a specific combat decoration or badge
(such as the Combat Infantryman Badge or Combat Action Ribbon) or award
for valor, it is often very difficult to establish that a veteran
engaged in combat with the enemy in order to trigger the combat
presumptions under title 38, U.S.C., section 1154(b). We must
recognize, however, that the very meaning of the term ``engaged in
combat with the enemy'' has taken on a whole new meaning as the nature
of warfare in today's world has changed. This is especially true of
service in the combat theaters of Iraq and Afghanistan.
Due to the fluidity of the battlefield and the nature of the
enemy's tactics, there is no defined frontline or rear (safe) area.
Military personnel in non-combat occupations and support roles are
subjected to enemy attacks such as mortar fire, sniper fire, and
improvised explosive devices (IEDs) just as their counterparts in
combat arms-related occupational fields. Unfortunately, such incidents
are rarely documented making them extremely difficult to verify.
Servicemembers who received a combat-related badge or award for
valor automatically trigger the combat-related presumptions of title
38, U.S.C., section 1154(b), but a clerk riding in a Humvee, who
witnessed the carnage of an IED attack on that convoy, doesn't
automatically trigger such a presumption and proving that the incident
happened or that he or she was involved in the incident, in order to
benefit from the presumption afforded under title 38, U.S.C., section
1154(b), can be extremely time consuming and difficult.
Given the evolving nature of modern warfare, as reflected in the
enemy's unconventional tactics in Iraq and Afghanistan, The American
Legion is of the opinion that it not only makes sense to clarify the
definition of ``engaged in combat with the enemy'' under title 38,
U.S.C. section 1154(b) in order to adapt to the new realities of modern
warfare. It is essential that we do so, not just for those serving now,
but for those who have served in the past and those who will serve in
the future.
H.R. 6032
The purpose of this bill is to amend title 38, U.S.C., to direct
the VA Secretary to provide wartime disability compensation for certain
veterans with Parkinson's disease.
Specifically, this bill, if enacted, would establish Parkinson's
Disease as a presumptive disability associated with Agent Orange/
herbicide exposure in Vietnam. The American Legion strongly supports
the addition to the presumptive list all conditions that have been
scientifically shown to be associated with Agent Orange/herbicide
exposure in accordance with provisions set forth in statute.
If Parkinson's Disease does not satisfy such criteria at this time,
The American Legion recommends further research to explore the
relationship between Parkinson's Disease and exposure to herbicides.
Conclusion
Thank you again, Mr. Chairman, for allowing The American Legion to
present comments on these important bills. As always, The American
Legion welcomes the opportunity to work closely with you and your
colleagues on enactment of legislation in the best interest of
America's veterans and their families.
Prepared Statement of John Rowan,
National President, Vietnam Veterans of America
Good morning, Chairman Hall, Ranking Member Lamborn, and other
Members of this distinguished Subcommittee. On behalf of the members of
Vietnam Veterans of America (VVA), we thank you for the opportunity to
appear here today to share our views on several of the bills up for
consideration. We ask that our full statement be entered in the record,
and I will briefly summarize the most salient points of our statement.
We'd like to begin with H.R. 5954, which would provide veterans for
presumptions of service connection for purposes of benefits for
diseases associated with service in the Armed Forces and exposure to
biological, chemical, or other toxic agents as part of Project 112.
We think some background is relevant here. Some 7 years ago, VVA
first learned of the then top-secret tests done at the height of the
Cold War under the rubric of Project 112. These included the SHAD tests
conducted mostly in the waters of the South Pacific as well as on land
in Alaska, Hawaii, and several other venues in the United States and
Canada; these tests were designed to measure the lethality of
biological agents and simulants for agents, e.g., bacillus globigii for
bacillus anthraxis, and the ability of U.S. vessels to repel them. They
also included tests of hallucinogens and other pharmacological agents,
mostly but not exclusively at Edgewood Arsenal and Fort Detrick. In the
former tests, sailors and other military personnel were participants,
not test subjects; in the latter tests, military personnel were very
definitely the test subjects. Some tests, like the SHAD tests,
commenced under Project 112; others, particularly the testing at
Edgewood and Detrick, began as far back as 1952.
Thanks to the efforts of Navy veterans like Jack Alderson of
California, and John Olsen of Montana, and Norman LaChapelle of
Tennessee (although he wasn't always from there), VVA became very
interested in the possible long-term health effects of exposure to the
agents and simulants that had been tested and the chemical
decontaminants that had been used to ``clean'' ships and tugs after a
test, or individual trials in a test, were completed. When we first
approached the Department of Defense, we were stonewalled; eventually,
DoD owned up to having planned some 134 SHAD tests and having completed
50 of them. We never learned as much as we would have liked to learn
about the Edgewood and Detrick tests, in part because of the
composition of our Task Force on Project 112/SHAD, which was heavily
weighted with SHAD veterans.
We applauded Congressmen Mike Thompson and Denny Rehberg when they
introduced H.R. 4952 in the 109th Congress. We applaud them again for
introducing H.R. 5954 in this Congress. We endorse H.R. 5954, but with
these caveats:
Because chemical and biological agents are not
necessarily toxic, language concerning exposure to ``a biological,
chemical, or other toxic agent . . .'' is not quite correct. Also, if
pharmacological products and hallucinogens are not embraced under
``biological agents,'' they must be specified at the risk of
inadvertently eliminating from the pool of veterans covered by this act
several thousand veterans who were in fact test subjects.
By essentially covering veterans who served from
``approximately 1963,'' those who participated in tests prior to that
year also would not be covered. This would be a miscarriage of justice,
inasmuch as testing conducted during the fifties was subsumed under
``112'' when Secretary of Defense McNamara divvied up the functions of
the Department of Defense into some 150 different functions. Covering
these veterans does not represent a ``fishing expedition.'' DoD is now
maintaining a registry of Project 112 veterans (as well as registries
of veterans who participated in lewisite and mustard gas testing during
World War II, and veterans who were part of any other tests of chem-bio
agents not embraced under Project 112).
VVA supports H.R. 5954, with the noted caveats, because it
represents a simple measure of justice. Veterans whose health has been
adversely affected by exposures during their military service warrant
healthcare and compensation for conditions shown to be positively
associated with such exposures.
H.R. 1197, The Prisoner of War Benefits Act of 2007, would repeal
the currently required 30-day minimum period of internment prior to the
presumption of service connection for certain diseases for purposes of
the payment of veterans' disability compensation; it would add diabetes
(type 2) and osteoporosis to the diseases already covered.
As with H.R. 5954, veterans (in this case former POWs) would be
covered ``whenever the Secretary [of Veterans Affairs] determines, on
the basis of sound medical and scientific evidence, that a positive
association exists'' between an experience of military service and the
occurrence of a disease in humans. This of course assumes that the
Secretary of Veterans Affairs and that bureaucratic structure,
including the notoriously anti-veteran bureaucrat's bureaucracy of
Office of Management & Budget (OMB), will act in a fair and impartial
manner. Often, nothing approximating veteran-friendly or even
impartiality is evident. In fact the opposite is more often than not
the case.
The flaw in the scenario of looking to the scientific evidence is
that quite often the government will not fund the needed research, and
all too often there is no reason for others to provide the resources to
do such research, so the veteran is left bereft as the government
either will not give the veteran access to key information citing
``national security'' when in fact it is only the desire to escape
culpability for damage done to the long term healthcare of veterans, or
they will not fund the research needed to prove the case one way or
another.
VVA endorses H.R. 1197, even though we recognize that it may be
difficult to secure passage because of ``PAYGO'' rules, unless an
appropriate offset can be found. Frankly, the Secretary of Veterans
Affairs should immediately seek a full review by the Institute of
Medicine (IOM) reading Parkinson's disease. If it turns out that there
is too little epidemiological evidence regarding veterans as determined
by IOM then the Secretary should be bound to fund such independently
conducted research as to be able to provide sufficient evidence that
will indicate whether there is evidence of statistical association or
not.
H.R. 3008, the Rural Veterans Services Outreach and Training Act,
would direct the Secretary of Veterans Affairs to carry out a program
to make competitive grants to provide financial assistance to state
departments of veterans affairs for the training of rural county
veteran service officers in order to improve outreach and assistance to
veterans, as well as their spouses, children, and parents, who may be
eligible to receive veterans' or veterans-related benefits and who are
residing in rural counties.
It is difficult to disagree with the goals of this legislation.
However, before VVA can support H.R. 3008, it needs a bit of tweaking.
Veterans service organizations, too, supply veteran service
officers to assist veterans and their dependents and survivors in
filing claims with the Veterans Benefits Administration. Should not the
VSOs, too, therefore, benefit from the largesse of this act? To direct
grants of up to $1 million annually exclusively to and for county
veteran service officers does a disservice to organizations like VVA,
DAV, VFW, and the American Legion who provide effective representation
to veterans.
Another weakness of this bill is that it does not recognize the
reality that some state and county service officers do not provide
representation before the Board of Veterans' Appeals, and other
organizations, e.g., VSOs, will not take on the cases of veterans in
the appeals stage. BVA representation ought to be mandatory for a
county's application for funding to be granted should this bill be
enacted.
We must also quibble with the definition of a county veteran
service officer. What is missing from this definition is that (s)he
must be accredited by the VA. Without this proviso, the law opens up
the possibility that uncertified service officers can be trained and
employed who do not meet VA requirements.
Last, there must be some sort of quality assurance and
accountability mechanisms built into this bill to ensure that what is
really needed--high quality representation by trained and dedicated
individuals who will help veterans residing in rural areas know the
benefits to which they are entitled and skilled help in receiving those
benefits--is actually the outcome that this proposed program is likely
to achieve.
If modified to meet the above criteria, then VVA would endorse such
a bill.
VVA applauds the impetus behind proposals such as this as the shape
of our current active duty force is the most rural we have had in a
century. Almost 40 percent of this active duty force (including
deployed National Guard and Reservists) come from towns of 25,000 or
less, according to DoD sources. Therefore, we (collectively) must
rethink the paradigm of the way in which we deliver veterans' benefits
and services of all types, whether it be the size and location of
national cemeteries, or medical care, or assistance in learning about
and securing hard earned veterans' entitlements and services.
H.R. 3070, The Disabled Veterans' Caregiver Compensation Act, would
require the Secretary of Veterans Affairs to pay monthly compensation
of $234 to a veteran if and while totally disabled and in need of
regular aid and attendance and while unpaid aid and attendance is
provided by an adult family member who is dependent upon such veteran
for support.
VVA's only question is: Why $234? Where did this figure come from?
Is it subject to annual COLA increases? Despite these questions, VVA
does support enactment of H.R. 3070, although we think that this
monthly amount is ridiculously low, and demeans the quality of care now
given by adult family members, and does not even begin to make up for
income lost when a spouse or parent or other quits work or takes only
part time work in order to have the time to care for the veteran.
H.R. 3795, The You Were There, You Get Care Act of 2007, presumes
specified diseases, and any other disease found by the Secretary of
Veterans Affairs to result from exposure to depleted uranium or the
byproducts of the burn-off that occurs when a depleted uranium munition
penetrates a target, among those diseases that will be presumed to be
service-connected (and therefore compensable) when appearing in
radiation-exposed veterans.
Perhaps the critical element in this bill is the provision for
independent medical study to determine diseases that may result from
exposure to depleted uranium. If, as is the case with dioxin, there is
compelling medical and scientific evidence that points to a positive
association between exposure and the onset of a particular disease,
then an exposed veteran surely warrants care and treatment and
compensation. If enactment of this bill leads to greater knowledge
about the potential health effects of exposure to depleted uranium, if
it can clear up some of the controversies over the claimed adverse
health effects of exposure, then it is worth the time of Congress to
enact it.
Keep in mind, however, that depleted uranium has been in production
since the late sixties and has been tested in weaponry at such places
at the Davy Crockett range in Hawaii. Is it fair to troops who may have
been exposed to DU in these tests not to be covered for possible harm
incurred during their service?
VVA supports H.R. 3795, but recommends expanding the group of
veterans to include all who were potentially exposed, including those
involved in testing this weapon.
H.R. 4274, The Gold Star Parents Annuity Act of 2007, would direct
the Secretary of Defense to pay a special pension to each person who
has received a Gold Star lapel button as a parent of a member of the
Armed Forces who died while serving.
VVA has long supported a pension for Gold Star Mothers who, in
their old age, we would like to believe would have been assisted by
their son or daughter had (s)he not died during a period of war or
afterward because of illness or injuries incurred during military
service. Frankly, however, the starting point for date of death should
be retroactive to at least include the parents of those killed in
Vietnam, even though the payments would only begin from the date of
enactment forward.
VVA at every level, local, state, and national, has a great deal of
contact with these wonderful people, many of whom are active in
American Gold Star Mothers organization. Many of them are clearly
struggling today. We would suggest that a further modification of the
proposed legislation be made so that such payments would not begin
until at least age 50, unless the individual recipient can show an
extreme hardship.
VVA also strongly urges the Committee to take action to end the
``widows tax,'' and to work with your colleagues in other Committees of
the Congress to stop the shameful action of offsetting Dependency &
Indemnity Compensation (DIC) at VA by the amounts received under the
Survivor's Benefits Program (SBP) at DoD. The current ``offset'' is
akin to reducing the amount of DIC because the servicemember had a life
insurance annuity with Metropolitan Life or some other private
insurance company. They paid premiums into the SBP for many years, and
so it a paid for benefit, and it is outrageous to deduct that amount
from the DIC. It is nothing short of an unjust ``widows tax.'' It is
way past time to rectify this injustice.
Additionally, VVA has testified many times about the crying need to
increase the amount of monthly payments under DIC. It is simply an
egregiously paltry amount that is paid to these dependents, and leaves
many Gold Star Wives below the poverty level. This is simply just not
right nor just. The founding principle of veterans' benefits is ``To
Care for Him who hath borne the battle, and for his widow and orphan''
in the great phrase of President Abraham Lincoln. Frankly, we are just
not living up to our obligation in this regard, and DIC must be
significantly increased as soon as possible.
VVA applauds the motivation of Congressman Walsh and this
distinguished body, but believes that it is the older parents who are
in most dire need today, and deserve to be included as a priority.
Further, the significant and valid needs of the surviving spouses must
be addressed with at least as much urgency as the significant and valid
needs of the older Gold Star parents.
H.R. 5155, The Combat Veterans Debt Elimination Act of 2008, would
prohibit the Secretary of Veterans Affairs from collecting certain
debts owed to the government by any veteran who dies as a result of a
service-connected disability incurred or aggravated while serving in a
theater of combat operations in a war after the Persian Gulf War or in
combat against a hostile force after September 11, 2001, if the
Secretary determines that the termination of collection is in the best
interests of the United States.
It is hard not to endorse this bill. One quibble that is perhaps
little more than theoretical: What if a veteran who owes the government
money is called back into service, or chooses to reenlist, and then
dies in a combat theatre of operations before a claim for a service-
connected disability has been adjudicated by the VA? VVA believes that
debt should be negated if he or she died in the line of duty, and not
passed on to the veteran's survivors.
VVA also believes that given the disaster that has been made of the
system of adjudicating claims that it is way past time to end the
current rule of ``the claim dies with the veteran.'' VVA recommends
that if a veteran dies, and a claim has been pending for more than 90
days, that said claim automatically be turned into a DIC claim for the
survivor(s), and that when finally settled, that if such a claim is
successful that full benefits up until the hour of death be paid, and
that the payments for DIC begin at that moment retroactively.
The veteran and their family should not be penalized for the poor
leadership and stewardship of the system that is supposed to adjudicate
veterans' claims, for, as General Bradley was fond of saying when he
led the VA: ``we are here to meet the veteran's needs, not our
bureaucratic needs.''
H.R. 5448, The Full Faith in Veterans Act of 2008, would direct the
Secretary of Veterans Affairs to accept as sufficient proof of service-
connection of post traumatic stress disorder (PTSD) alleged to have
been incurred in or aggravated by active military service a diagnosis
of PTSD by a mental health professional, together with a written
determination that such PTSD is related to the veteran's service, if
consistent with the circumstances, conditions, or hardships of such
service, notwithstanding that there is no official record of such
incurrence or aggravation during such service.
With all the focus on PTSD these days--Is the VA refusing in at
least some locations to diagnose PTSD in cases to somehow save money?
(VVA thinks this may be the case, as events at Temple VAMC in Texas
have shown recently). Is there a battalion of ``shirkers'' out there
who will fake symptoms in order to get some free money? (VVA has good
reason to believe this to be a fevered delusion of one notorious
``scientist'' who never has any real data, but who shouts out this
garbage nonetheless.) does address some pressing and timely issues. It
does, however, have certain flaws.
Part of the purpose of H.R. 5448 is ``to improve the diagnosis and
treatment of post traumatic stress disorder by the Secretary of
Veterans Affairs.'' Well, Dr. Peake neither diagnoses nor treats
personally, but more importantly, this bill has nothing to do with
diagnosis and treatment; rather, it is about service-connection. Also,
while this bill addresses PTSD, it neglects other mental disabilities
linked to one's military service, which may also (and often is)
directly linked to military service, particularly in dangerous
situations.
Furthermore, as evidence in support of this bill, VVA reminds the
Committee that the Doherwend, et al. study published in August of 2006
that revisited the National Vietnam Veterans Readjustment Study (NVVRS)
went back to all who claimed exposure to traumatic events in that 1986
survey/study. The researchers then tried through searching unit
histories, after-action reports, newspaper and other news coverage, and
other sources and tried to objectively show that the violent event did
occur at the time and place self-reported by the veteran. What they
found was that 91 percent of the claims could be verified as having
occurred, at least there was written or printed materials that
substantiated the veterans' professed exposure was either proven, was
shown to be likely, or was at least proven to be plausible. Insofar as
the other 10 percent or so of claims of traumatic events, the
researchers stressed the fact that they could not find any
substantiating records certainly did not mean that the event self-
reported by the veteran did not occur. War is by its very nature messy
and confusing, and often things happen that are not fully recorded,
even though neat and tidy documentation is supposed to always happen
according to the military's bureaucracy. Those of us who have been in a
war zone know that the reality is often different.
Further, the VA Office of the Inspector General Report No. 05-
00765-137, ``Review of State Variances in VA Disability Compensation
Payments'' randomly sampled about 2,300 claims folders that had been
adjudicated as being 100 percent for PTSD (many were 100 percent only
when combined with individual unemployability) from a number of VA
Regional Offices, in both large states and rural states. After a
protracted uproar regarding charges by the OIG in press statements
alleging fraud, the 2,300 files were sent to the Office of the
Undersecretary for Veterans Benefits. He assembled a team that went
through each claim carefully to weigh the evidence, and thoroughly
asses each case. Out of the roughly 2,300, only two were found to merit
full scale investigation by the IG, and these two were forwarded back
to IG to further investigate. Ultimately the IG found that there were
significant errors made in these two cases, but could not find any
evidence of fraud or intent to fraud.
This stands as a solid testimonial to the integrity and honor of
those who file PTSD claims. VVA believes that many who legitimately do
suffer from PTSD have their claims denied because there are no
immediate documents that the individual veteran can access to prove his
or her case. (The VA has the resources and the access to secure the
evidence if their ``duty to assist'' were not constantly being made
into a mockery by the way they actually do business.)
This legislation is long overdue, and is much needed. As long as
reasonable plausibility is established as to the traumatic event, and
the VA is directed to use proper diagnostic tools to determine that the
individual in fact has PTSD (which they often do not, due to poor
training, poor leadership, poor measurement metrics, and cost cutting
taking precedence over best clinical procedures), VVA supports H.R.
5448.
H.R. 5454 would establish a presumption of service connection for
amyotrophic lateral sclerosis if a veteran develops a 10 percent degree
of disability or more at any time. Although it is unclear from what
we've read of this bill, we assume that veteran must have served during
the Persian Gulf War. This being the case, VVA supports enactment of
this bill.
H.R. 5709, The Veterans Disability Fairness Act, would require the
Secretary of Veterans Affairs to carry out quality assurance activities
with respect to the administration of disability compensation.
This bill, while well-intentioned, seems to ask for the obvious: to
help ensure ``the accuracy and consistency across different offices
within the Department of the treatment of claims for disability
compensation, including determinations with respect to disability
ratings and whether a disability is service-connected.'' Yet anything
that will help the VA achieve accuracy and consistency in this regard
is to be commended. Competency based testing of all VBA employees and
those accredited to represent claimants, full meaningful accountability
for supervisors and managers, and generally solid leadership from the
top down would go a long way toward cleaning up the mess that this
system has become, as well. The lack of proper automation of this
system has been covered by all concerned so often that the yawning need
for progress on this front goes without repeating.
Hence, VVA endorses H.R. 5709.
H.R. 5985, The Compensation for Combat Veterans Act, would
``clarify the service treatable as service engaged in combat with the
enemy for utilization of non-official evidence for proof of service-
connection in a combat-related disease or injury.''
While we had difficulty deciphering just what the above seems to
mean, we do not have difficulty in understanding that the definition of
a ``combat veteran'' under this act is a bit broad. While it is true
that even a well-protected rear area in South Vietnam could be subject
to mortar and rocket attacks and infiltration by sappers, the construct
that simply to be in a combat zone means one should be treated ``as
having engaged in combat with the enemy'' doesn't hold up. It demeans
those troops who in fact do engage in combat with the enemy.
A clerk in Long Binh in 1970, while in a putative combat zone,
lived in effect in a city. To give him, or her, the same status as an
infantryman is simply wrong. On the other hand, we know many veterans,
of both Vietnam and the current conflicts, who had military jobs that
were ostensibly ``non-combat'' such as engineers or truckdrivers who in
some case had much more direct engagement with the enemy under hostile
fire than some who had an infantryman's designation. Today the military
recognizes at least some of these persons with a combat action badge.
However, that is not the case for those who served in Gulf War I,
Vietnam, or earlier conflicts.
The notion that only those with a Combat Infantryman's Badge (CIB)
have been exposed to combat, or the hazards of a combat theater of
operations, is far too narrow. The notion is this bill may well be far
too broad. There needs to be further development work regarding the
intent of this bill, and whether there is a better way to achieve that
objective. Further, at least part of what may be the intent of this
bill may well be covered by H.R. 5448.
VVA cannot endorse H.R. 5985 in its present form without further
work, and without better understanding the aim of this proposal, which
is not immediately ascertainable.
H.R. 6032 would direct the Secretary of Veterans Affairs to provide
wartime disability compensation for certain veterans with Parkinson's
disease.
There is significant scientific evidence that associates the onset
of this malady with one's military service in Vietnam veterans in
particular, due to exposure to Agent Orange, Agent Pink, and the
potpourri of other poisons in the toxic soup in which we lived and
fought during the Vietnam War. VVA has no difficulty in supporting
enactment of this bill.
On H.R. 6114, The SUNSET (Simplifying and Updating National
Standards to Encourage Testing of the Human Immunodeficiency Virus) ACT
of 2008, VVA takes no position.
H.R. 6122 would direct the Secretary of Veterans Affairs to develop
and implement a comprehensive policy on the management of pain
experienced by veterans enrolled for VA healthcare services.
It seems to us that the Veterans Health Administration already
takes a pro-active interest in pain; certainly, just about every
veteran who is examined by a nurse is asked about his/her level of
pain. Still, while this bill seems a bit redundant with what the
Department is already doing, VVA supports its enactment, particularly
with regard to the VA's program of research into acute and chronic pain
suffered by veterans.
VVA thanks the Subcommittee for the opportunity to comment on these
bills, and will be pleased to reply to your questions.
Prepared Statement of Lieutenant Commander
Jack B. Alderson, USNR (Ret.), Ferndale, CA
Chairman Hall, Ranking Member Lamborn and Distinguished Members of
the Committee. My name is Jack B. Alderson, and I live in Ferndale,
California. I am a retired Lieutenant Commander from the U.S. Navy
Reserves and am here today to describe my experiences within the
``Project SHAD Technical Staff'' (PSTS).
In 1964 I was a Lieutenant on active duty in the U.S. Navy and
received orders to the ``Project SHAD Technical Staff'', as Officer in
Charge of a Division of five U.S. Army Light Tugs (LTs) at Pearl
Harbor. The mission of the PSTS and the LTs were to test at sea
Chemical/Biological Weapons. I was there from September 1964 until
August 1967. The LTs acted as sampling stations and read targets for
disseminated weapon clouds.
Each LT was manned by a Navy crew with a U.S. Navy Lieutenant as
OinC. The LTs were Army vessels with Navy crews operating under a Joint
Services Command. These were not volunteers, but hand picked personnel
with ``Final Secret'' clearance ordered to do a job. That job was done,
and done well. During the 3 years I was with the PSTS LTs, they never
missed a commitment, and completed all tasks assigned while maintaining
a fine safety record. This was, at times, a very dangerous job with
stringent safety precautions and procedures in place.
I herein stress, that we took every safety precaution within the
technologies and knowledge available in the 1960's. Sometime later I
became aware that some of the PSTS personnel were having health
problems; namely, respiratory and cancer. A knowledgeable medical
person connected with the tests stated to me that ``some of the
materials used to decontaminate the LTs after a test are now known to
be carcinogenic''. Decontamination agents used were Betapropiolactone,
Formalin, Ethylene Oxide and HTH (Chlorine). Please see attachment.
Further concern is here for the PSTS staff, as the FDA had not approved
the inoculations administered to them. Security conditions precluded
any of this being placed in our official health records. In fact, some
of our health records are missing.
Upon return to Pearl Harbor the PSTS, including the Light Tugs took
part in training and in tests involving simulants. Named tests included
Fearless Johnny, Big Tom, Folded Arrow and others on and around the
Hawaiian Islands. Some of these simulants have now been shown to have
harmful affect on humans when exposed. The decontamination agents and
procedures are the same as for the live weapons tests.
I also took three of the LT's on two Bird Cruises. Wherein we had
on board scientists including ornithologists from the Smithsonian
Institute. The purpose of the Bird Cruises was to make sure none of the
indigenous birds of the central Pacific were carrying any residue of
the tests.
After I left the PSTS in 1967 they continued to operate for a
number of years. Some of their operations were off the California
coast. I know this because I was then assigned to ``Fleet Training
Group San Diego'' where I wrote the weekly operation order assigning
operating areas and training assets. In 1968 I received a request for
operating areas for the USS Herbert J Thomas (DD833) and five Army
Light Tugs. Since some tugs sailors and I had trained the DD I can
guess what they were doing.
My concern is for the personnel of the PSTS, who with full trust in
their country, did what they were told to do and did it well. Many of
these persons are dead, and many have health problems that may well
have started with their participation in SHAD. Importantly, their
present attending physician would not equate present health problems to
something that happened many years ago.
As I stated, I became aware of the problem some years ago when I
heard from the SHAD veterans that they could not get care at VA clinics
and were turned away because they could not fully describe what
occurred to them. At first we were told that no such testing happened.
The Army said they had concerns but took no action until forced. In
fact, a letter dated August 23, 2000 from Maj. General J. M. Cosumano,
Assistant Deputy Chief of the Army, states that everything remains
classified but only simulants were used, and protective clothing worn .
. . Untrue.
During the initial efforts to expose what was happening to SHAD
veterans I found I had a severe Malignant Melanoma and that brought
home to me the concerns of other SHAD veterans. I now have other health
concerns possibly attributable to SHAD operations.
On September 13, 2001, DoD released three sets of FACT SHEETS. One
set was for ``Operation Shady Grove'', listing as participating units
the 5 LTs.
Upon completing our training and inoculations we were considered
ready to participate in test operations. We were ordered to standby to
get underway on 2 January 1965. We were ready, and then told to stand
down as the President has not signed the operational document.
President Johnson did sign, and we were underway for Johnston Island on
21 January 1965 for ``Operation Shady Grove'', the testing of
Biological Weapons, simulants and trace elements. This operation was
under control of the Deseret Test Center, Fort Douglas Utah and
personnel from Dugway Proving Ground.
The aforementioned ``FACT SHEETS'' are incomplete and contain
erroneous information such as dates of test and not naming
decontamination agents as examples.
``Operation Shady Grove'' was staged from Johnston Island. Prior to
commencement, the LTs were scripted for the next 6 days of operation as
radio silence was imposed. The LTs would pick up the test sampling
material and animals from the USS Granville S Hall (YAG 40), Granny,
and proceed to their assigned position on the grid. At twilight the
monkeys were placed in cages topside, and the LT buttoned up. U.S.
Marine A 4s would disseminate the agent, simulants and trace elements
up-wind of the LTs and down wind of the Granny. The weapons cloud would
then drift down over the grid while samples were being taken. In the
morning, the exterior decontamination crew would exit the interior and
decontaminate the exterior, including wrapping up the monkeys for
transfer to the Granny. Even though the Light Tugs had air pressure and
filtering systems, they leaked. We know this from the instruments
inside the tugs. We were not worried as we were inoculated . . . Right?
After 6 days of operations the LTs would return to Johnston Island
for a three-day rest and repair. During this break sometimes the tugs
were decontaminated on the interior. Our decontamination agents are now
considered carcinogenic.
Personnel from the Deseret Test Center and Dugway have often stated
that LT crew should have been in protective clothing during a test and
we were not. In fact, there was none on the LTs. The exterior
decontamination crew wore cotton coveralls with rubber bootie and
gloves, plus a gas mask. Exterior decontamination was done by a crew of
three by hand using HTH in a soapy solution. These three were the only
members with gas masks. When they completed decontaminating they
stripped placing every thing they wore in a metal trashcan, taping it
shut and through a fitting releasing an aerosol of Ethylene Oxide onto
the clothing, entering the vessel through an air lock and showering on
the way. There were no washing machines on the tugs, so the next day
the exterior crew donned their equipment and did it again. Ethylene
Oxide ia a known Carcinogen as is HTH.
Periodically it was necessary to decontaminate the interior of the
tugs. This was accomplished by using a fogging device with the fog made
from Betapropiolactone and Formalin, both of which are highly
carcinogenic. To make sure the fog penetrated everywhere every locker
every drawer was open the only sealed item was the galley refrigerator.
After a period of time the tugs were opened up and aired out. However,
when we went inside the liquid was running down the bulkheads and the
interior atmosphere caused our eyes to smart and some personnel
received rashes. Our bunks and clothing were damp from the fog.
I understand security classifications and the sensitivity of our
operation. However, these were not volunteers but service personnel
ordered to do a dangerous job and they did it, and did it well, now
their Nation needs to take care of them.
I thank Representative Mike Thompson who has stuck with us for a
number of years even while members of the administration said there was
no SHAD. Appreciation also goes to Representative Rehberg for joining
in this task.
I thank you Chairman Filner, Ranking Member Buyer, and Members of
the Committee, and herein respectfully request that H.R. 5954 be moved
from Committee to the Floor of the House with the recommendation for
approval.
If you have any questions I will try to answer them.
Prepared Statement of Jeff Faull,
McEwersille, PA (Disabled Veteran), on behalf of The ALS Association
Good afternoon Chairman Hall, Congressman Lamborn and Members of
the Subcommittee. My name is Jeff Faull and I am from a small town in
northeastern Pennsylvania called McEwensville. I appreciate the
opportunity to speak with you this morning on behalf of The ALS
Association and veterans living with ALS across the country. I hope
that by sharing my experience with you today, you will gain a better
understanding of how this disease impacts veterans across the country
and why H.R. 5454 is so urgently needed.
Before I begin, I would like to thank Congressman Henry Brown and
Congressman David Price for their leadership in introducing this vital
legislation. Veterans with ALS across the country truly are grateful
for their efforts.
I joined the Navy in 1992 at the age of 24 and served two tours of
duty as a nuclear electronics technician (Navy Nuke), including over 4
years aboard the U.S.S. Theodore Roosevelt. During that time I
participated in Operations Southern Watch, Deliberate Force, Allied
Force and Noble Anvil. Prior to my assignment aboard the Roosevelt, I
was stationed at the Knolls Power Laboratory Kesselring Site in West
Milton, NY located not too far from your district Mr. Chairman.
I left the Navy in 2000 to spend more time with my wife Tammy and
our two daughters Tiffany and Breanna. Like many other veterans, I
never thought that my service in the military would cause health
problems years after I left the service. I never thought that I would
have to fight to obtain benefits from the VA and I never thought I
would be sitting here before you today having been diagnosed with ALS,
or Lou Gehrig's disease. But for me and thousands of veterans across
the country, the reality is that, years--and even decades--after
serving our country, we are being diagnosed with ALS and we are
fighting for benefits at the same time we are fighting this disease.
I was diagnosed with ALS just over a year ago in February 2007 at
age 38, about 20 years younger than the typical person with ALS. At the
time, I had no idea what ALS was. Amyotrophic lateral sclerosis meant
nothing to me, as I'm sure it means nothing to thousands of others when
they are first diagnosed. But I can assure you it's a whole different
story when your doctor uses phrases such as ``unfortunately, you don't
have cancer.'' That's when you begin to understand how serious ALS
really is.
ALS is a rapidly progressive, invariably fatal, neurological
disease that attacks the neurons responsible for controlling voluntary
muscles. To put it simply, this disease will rob me of my ability to
walk, talk, move and breathe. There is little I can do to slow the
progression of the disease as there is no effective treatment available
for ALS, nor is there a cure. The disease is usually fatal in about two
to 5 years. In fact, of the more than 2,000 veterans who have enrolled
in the VA ALS registry over the past 4 years, less than 900 are still
with us today.
I first noticed the symptoms of ALS as early as 1999 when I
experienced cramps and twitching in my left hand and arm. As time
passed, I began to develop weakness then loss of muscle mass, which
eventually led to my diagnosis last year. Since my diagnosis, the
weakness and atrophy which began in my left hand has not only worsened
but spread. Both hands and arms are now weak, walking is becoming more
difficult and, as you can hear, my speech is beginning to be affected.
I keep a pair of slip-joint pliers in the kitchen to help open
things. My wife Tammy who's with me here today normally makes sure that
things like cereal boxes are opened for me otherwise I have to ask for
help from my daughters. Although they are more than happy to help their
``old man'' this is not how I pictured spending my time with my
daughters. I can't make the walk to see Breanna play soccer. I don't
have the arm strength to shoot a basketball with my older daughter
Tiffany. I will more than likely be in a wheelchair when it comes time
to teach them to drive. These are the treasures this disease steals
from thousands of veterans every year. That is, before the disease
takes our lives.
Several studies, including studies funded by the Department of
Defense and the Department of Veterans Affairs have found that military
veterans of the 1991 Gulf War are approximately twice as likely to
develop ALS as those not deployed to the Gulf. As a result, the
Secretary of Veterans Affairs established a presumption of service
connection for those veterans with ALS who served in the SW Asia
Theater of Operations from August 2, 1990 to July 31, 1991.
However, the increased risk of ALS is not confined to veterans of
the Gulf War, nor is it limited to veterans who served during a time of
war. Researchers at Harvard University have found that military
veterans from other eras, ranging from before World War II to after
Vietnam, also are nearly twice as likely to develop ALS as those who
have never served in the military. The study did not even consider Gulf
War veterans. Moreover the study showed that veterans were at greater
risk of ALS regardless of whether they served during a time of war or
peace, or whether they served at home or abroad.
The Institute of Medicine reviewed these and other studies and
reported in November 2006 that existing evidence supports the increased
risk of ALS for veterans. In fact, I understand that recent research,
which has not yet been published, suggests that ALS is occurring at
greater rates in those who are serving in the current conflict in Iraq.
And what's alarming about this information, and the evidence from prior
research is that we are seeing ALS in veterans at an age when we
generally do not see the disease. I was 38 when I was diagnosed. Most
people are diagnosed in their fifties, sixties and 70s. What will we
see 10, 15, 20 years in the future as the men and women serving today
leave the military?
It is clear that regardless of when or where someone served in the
military, they are at a greater risk of dying from the disease than if
they had not served in the military.
The Department of Defense and the VA also recognize that there is a
relationship between military service and the development of ALS. In
addition to Gulf War veterans, veterans who experience symptom onset or
are diagnosed with ALS while on active duty or within 1 year of
discharge are presumed service connected. DoD, VA and Congress also
have invested funding for ALS research, including establishing the
Veterans ALS Registry at the VA and creating the peer reviewed ALS
Research Program at DoD, which is seeking treatments for veterans with
ALS.
However, despite the evidence showing that all U.S. military
veterans are at a greater risk of ALS, the VA has not created a
presumption of service connection for all veterans with ALS. Thousands
of veterans continue to be left behind and hundreds of thousands
serving in the military today, including in Iraq and Afghanistan,
continue to be at a greater risk of dying from the disease.
The VA will respond that any veteran with ALS can be granted
service connection on the basis of specific evidence supporting their
case. As someone who has been denied service connection, and knows
countless others who have as well, I can tell you that this response
demonstrates a lack of understanding of the disease.
The reality is that the majority of veterans with ALS, who do not
fall under the current limited presumptions, are forced to fight for
their benefits. And we are usually denied. I have been attempting to
establish service connection for over a year now and have submitted
reams of scientific and medical evidence, including letters supporting
my claim from my neurologist. Yet that evidence has fallen on deaf
ears.
Part of the problem we face is the nature of the disease itself.
ALS is an insidious disease. First the symptoms, such as the ones I
experienced while on active duty, are so benign that they go unnoticed
or unreported. How many of us in this room have experienced muscle
cramps and twitching and thought nothing of it? These are symptoms of
ALS, yet they are not documented in our service medical records simply
because we did not think they were a big deal at the time--after all,
we were in the military. How many of us on active duty actually thought
that we would succumb to muscle twitching?
In addition, it can be years from discharge until the onset of
symptoms or between onset and diagnosis--well after the 1 year
presumptive period has ended. And there is no simple way to diagnose
ALS, no single test you can take that says you have ALS. Rather it is a
diagnosis of exclusion, made by ruling out every other possible
diagnosis.
The bottom line is that if you were not diagnosed while on active
duty and did not serve in the Gulf, the VA likely will not consider ALS
to be service connected. This, despite the studies and the fact that
the VA and DoD both recognize ALS to a high priority for research.
In addition to the studies that I have referenced and which are
included in the ALS Association report, ALS in the Military; the
Unexpected Consequences of Military Service, there are multiple peer
reviewed studies linking ALS to many of the things our military
personnel are exposed to on a regular basis. These include ionizing and
non-ionizing radiation, fuels, solvents, lead, vapors and vaccinations.
In fact, recent peer reviewed studies and World Health Organization
guidelines link some of the vaccines given to our military personnel as
a possible cause of ALS.
My question, as a veteran with ALS trying to establish service
connection is what additional proof must I provide? How many more
studies are needed? How many veterans have to develop ALS and die from
it before the VA takes action?
I can only hope that this quick glance into my life with ALS and
attempts with service connection grant you the understanding to see the
importance of establishing a presumption of service connection for all
veterans with ALS, which is exactly what H.R. 5454 would do. We have to
fight for our lives. We should not also have to fight for the benefits
that the evidence shows we deserve.
Abraham Lincoln's statement which was later adopted by the VA as
their motto states, ``to care for him who shall have borne the battle
and for his widow, and his orphan''. I and the other veterans with this
horrible disease appreciate your time and effort to ensure that
statement is more than words. I urge you to support H.R. 5454 and help
ensure that no veteran with ALS is ever left behind. Thank you again
for your time and the opportunity to speak with you.
Prepared Statement of David Woods,
Director, Veterans Affairs of Scott County, IA
Mr. Chairman and Members of the Committee, thank you for allowing
me to be here today to discuss Congressman Braley's bill, The
Compensation for Combat Veterans Act. I am the Director of Veterans
Affairs of Scott County in Iowa. I am also a Vietnam combat Veteran. I
have been awarded the C.I.B., the Purple Heart and the Silver Star from
being wounded June 12th 1970 in Nam. So I have a feeling for just what
our Veterans are going through.
My job as a Veterans Service Officer for Scott County is to listen
to these Veterans, get them the medical help and compensation which is
due them. I also help them through the Veterans Administration tangle
of paperwork and to make sure that they understand what they are
entitled to. Having witnessed my combat experiences, I understand and
am able to talk and relate to what these Veterans are going through.
They will tell me things that they have told nobody else, not even
their wives or family.
I have had Veterans come into my office asking him where, when, and
what unit were you with, who was wounded or killed near you. He just
stared at me and replied that he had no idea what the date was or maybe
they were working with a different unit than his own, so he had no idea
who the guy was that got wounded, but the Veteran was there.
Now, how about our Vietnam Veterans who have been trying to forget
his time in Vietnam, the cases of PTSD are rising since the start of
the Iraq, Afghanistan Wars. After 40 years, have him try to remember
when he was attacked or even the name of a buddy who was injured. I
know that when most of us were in combat we did not have calendars with
us and as to where we might have been, we just followed our leader's
orders. Asking these questions sometimes just brings back bad memories,
memories which we were trying to forget.
For our Iraq, Afghanistan Veterans, there are times when that MP or
engineer or even a cook might be pulled from his job and be sent on
convoy duty. Many times when that change happens, it is not documented
for the files. Then when he is sent on that job, he might not be
working with his own unit or his combat buddies. If they receive
incoming rounds it is not documented; it's just an everyday occurrence.
I have had National Guard Veterans whom had been activated, come
into my office for compensation claims, which we filed. The Veterans
Administration has turned down these claims because part of the units
were still on duty and all of the units' records were still over with
the rest of the unit. Then we had to track down a buddy that might have
witnessed what had happened to the Veteran. Now with the Guard you have
to remember that they might not see that certain buddy until drill
weekend, if they drill together in the same unit. Also their days also
ran together and they had no idea when they were fired on. When they
were in a certain village or city they at least knew that much.
I have had an Iraqi Veteran with T.B.I. (Traumatic Brain Injury)
file for compensation but because he had no C.B.I or Purple Heart or
other combat medal, he was turned down by the VA for his compensation.
His DD 214 showed that he was in Iraq listing the date and unit, but
nothing else. When we filed the compensation claim, that Veteran was
tested and treated at the Iowa City VA Medical Center. He was found to
have T.B.I. and he was awarded his compensation claim.
If you were to ask a combat medic just what his job was, you would
be told that he was to keep that injured soldier alive and to let the
people in the background do the paperwork. If you were to look at my
medical report, it says that I was injured in the left arm and the
neck. Neither happened to me when I was hit. That medic did not carry a
file for each of us to report every little wound or knock to us. It was
not possible and it's still not possible to keep track of these
records.
Case in point, I had a W.W. II Veteran come into my office wanting
to get his Purple Heart which he had never gotten. His records were
burned up in St. Louis and he really wanted it for his family. He was
injured in Germany and sent to France for his medical treatment. While
in the hospital in France he was told that his Purple Heart would be
given to him when he got back to his combat unit. On returning to that
unit he was informed that he should have received it while in France.
He just wanted to get home so he forgot about it until his kids asked
about his awards. While talking to him I found out what unit he was
with and when and where he was injured. I sent a message to the Unit
Records section in St. Louis; when we got the response with his name on
the records, it said that he was in the hospital for illness not an
injury. Since the other tank members were all deceased, he was dead in
the water for his Purple Heart. Just another show of great military
records keeping for the Veteran.
I had a Vietnam Veteran come into my office to apply for
Compensation for Agent Orange Type II Diabetes. This Veteran was a Navy
deep water Veteran and when he applied for his compensation, the VA
turned him down stating the ``Hass vs. Nickelsen'' case that he was
never in Vietnam. I asked the Veteran if he had contact with any of his
shipmates and the very next day he had e-mail addresses for two of his
shipmates. I contacted one of the two, and it turned out that he was
the third officer on the ship. His letter back to me was a statement
telling that it was common knowledge that the replacements would fly
into Vietnam, truck 2 days down to the tip of Nam, and then be boated
out to the ship. Then to add insult to injury to the VA and the records
keeping, he mentioned that every two or 3 months they would all land on
an island beach off of Vietnam for volleyball and R & R. We are still
waiting to hear from the VA on that case.
These are just a fraction of the Compensation Claims which we are
fighting with the VA. These last wars are not like W. W. I and not like
W. W. II where you knew whom the enemy was or where the frontlines
were. Now we have no lines or enemies in a certain uniform. There are
not many ``safe areas'' when the Veterans of today can actually relax.
It doesn't take much incoming to put stress and pressure on our
Veterans and that is what we are finding out today.
Thank you for letting me speak to you today.
Prepared Statement of Bradley G. Mayes,
Director, Compensation and Pension Service, Veterans Benefits
Administration, U.S. Department of Veterans Affairs
Mr. Chairman and Members of the Committee, I am pleased to be here
today to provide the Department of Veterans Affairs' (VA) views on
pending benefits legislation. Accompanying me is Richard J. Hipolit,
Assistant General Counsel. VA is still reviewing H.R. 5448 and will
provide views on that bill in a subsequent views letter.
H.R. 1197
H.R. 1197, the ``Prisoner of War Benefits Act of 2007,'' would: (1)
repeal the current minimum 30-day internment period required for
veterans who are former prisoners of war (POWs) to be entitled to
presumptive service connection for the disabilities listed in 38 U.S.C.
Sec. 1112(b)(3); (2) add type-2 diabetes and osteoporosis to the list
of disabilities presumed service connected for former POWs; and (3)
authorize VA to administratively determine, and establish procedures
for such determinations, whether to add or remove diseases from the
list of POW presumptions. The bill would require VA, in making such
determinations, to take into account the recommendations received from
the Advisory Committee on Former Prisoners of War and, whenever that
Committee recommends that a presumption of service connection be
established for a disease, to make the determination not later than 60
days after receipt of the recommendation. VA would have 60 days after
that to either propose regulations to implement a positive
determination or publish a notice of a negative determination. Final
regulations would be required not later than 90 days after any proposed
regulations are issued.
VA does not support this bill for the following reasons:
The diseases already listed in section 1112 have been medically and
scientifically associated with the harsh physical and psychological
conditions associated with POW internment. It is unreasonable to assume
that the extreme deprivation associated with the diseases listed in
section 1112(b)(3) occurred during internment periods of less than 30
days, particularly those diseases associated with nutritional
deprivation. These diseases include avitaminosis, chronic dysentery,
helminthiasis, malnutrition, pellagra, cirrhosis of the liver,
peripheral neuropathy, irritable bowel syndrome, peptic ulcer disease,
atherosclerotic heart disease or hypertensive vascular disease and
their complications, and stroke and its complications.
VA is not aware of any credible scientific or medical literature or
study that has associated type-2 diabetes mellitus or osteoporosis with
POW internment.
The timeline S. 1197 would mandate for making determinations and
publishing regulations is untenable. Determination of whether any
particular malady should be added to the list of diseases warranting
presumptive service connection must reasonably involve a lengthy
process of scientific study. Sixty days is insufficient time for the
Secretary to be able to evaluate a recommendation to create a new
presumption.
We estimate the benefit costs of this bill to be $61.1 million
during fiscal year (FY) 2009, $440.1 million for 5 years, and $798.2
million over 10 years. The bill would minimally affect workload, so
full-time employee (FTE) costs would be insignificant.
H.R. 3008
H.R. 3008, the ``Rural Veterans Services Outreach and Training
Act,'' is intended to improve outreach and assistance to veterans and
their dependents who may be eligible to receive VA benefits and are
residing in rural counties, through the training of rural county
veteran service officers. To this end, H.R. 3008 would establish a
competitive grant program to provide financial assistance to state
departments of veterans affairs.
Although VA supports the intent of H.R. 3008, we oppose the bill
because it would duplicate ongoing efforts by the Veterans Health
Administration's Office of Rural Health (ORH) to address the health
care needs of veterans in rural areas, as well as duplicate other
outreach activities already conducted by VA for veterans in rural
areas.
The ORH has been initiating innovative programs to improve care and
services for veterans who reside in geographically isolated areas,
including the following:
Rural Mobile Healthcare Clinic: The ORH recently
disseminated a nationwide Rural Mobile Healthcare (RMHC) Clinic Pilot
Request for Proposals, to extend access to primary care and mental
health services in rural areas where it is not feasible to establish a
fixed access point. Although the primary focus of RMHC is to enhance
the delivery of care to rural veterans, secondarily it can address
outreach and collaborate with community partners. The ORH expects to
complete the selection of the pilot sites by the end of summer 2008.
Veterans Integrated Service Networks Rural Consultants:
The use of Veterans Integrated Service Networks (VISN) Rural
Consultants was mandated by section 212 of Public Law 109-461. The
consultants will enhance service delivery to veterans residing in rural
areas, will lead activities in building an ORH Community of Practice to
facilitate information exchange and learning within and across VISNs,
and support a stronger link between ORH and the VISNs. The ORH recently
disseminated a nationwide Request for Proposals and intends to fund
eight consultants. We expect to complete selection of consultants by
the end of 2008.
VA believes the results of the RMHC Pilot Initiative and the VISN
Rural Consultants program will enhance healthcare services for veterans
and guide the future direction of other potential initiatives, such as
those contemplated by H.R. 3008.
In addition to the abovementioned rural healthcare initiatives, the
following are examples of other outreach services occurring in rural
areas:
Vet Centers provide readjustment counseling and outreach
services to all veterans who served in a combat zone. Certain services
are also available for their family members. The goal of the Vet Center
program is to provide a broad range of counseling, outreach, and
referral services to eligible veterans to help them successfully
readjust to civilian life. The Vet Centers are community-based and
staffed by small multi-disciplinary teams of dedicated providers, many
of whom are combat-veterans themselves. The Vet Center staff routinely
visits rural communities to provide outreach and direct readjustment
services. The Vet Center program has initiated its own community
outreach vehicle project and is in the process of selecting sites for
50 outreach vehicles. The measures outlined in H.R. 3008 would be
duplicative of their efforts.
VA is conducting a substantial amount of outreach,
counseling, and education for returning Reserve and National Guard
members and their families. Effective May 1, 2008, at the Secretary's
request, an estimated 570,000 Operation Enduring Freedom and Operation
Iraqi Freedom (OEF/OIF) veterans are being contacted and given
information on VA medical services and other benefits available to
them.
VA currently engages in a range of activities to educate
VA staff and other agencies and organizations involved in helping
veterans and dependents, such as community service providers, school
officials, lenders, service organizations.
The Healthcare for Homeless Veterans Outreach program.
The Tribal Veteran Representative programs.
Seamless transition programs for OEF/OIF veterans.
Educational patient support groups
VA's outreach efforts also include activities that assist veterans
generally, such as attending benefit fairs and exhibits at conferences,
conventions, veteran service organization meetings, Federal boards, and
townhalls, and participating in a range of Department of Defense-
related activities such as Transition Assistance Program (TAP)
briefings and National Guard and Reserve component conferences.
H.R. 3008 has insufficient detail to fully develop a cost estimate.
The grant costs associated with this bill could range anywhere from no
cost to $50 million annually. VA would incur additional costs to
administer the program, but we are unable to determine FTE costs at
this time.
H.R. 3795
H.R. 3795, the ``You Were There, You Get Care Act of 2007,'' would
add to the list in current law of diseases presumed to be service
connected for a radiation-exposed veteran any other disease ``covered''
under 38 CFR Sec. 3.309 or 3.311, as well as any other disease found by
VA to result from exposure to depleted uranium or the by-products of
the burn-off that occurs when a depleted uranium munition penetrates a
target. H.R. 3795 would also require that a veteran who served in the
Persian Gulf War or any subsequent conflict in which depleted uranium
munitions were used, if that service was in a theater of operations or
involved the clean-up or servicing of vehicles or equipment that had
been in such a theater of operations, be considered a ``radiation-
exposed veteran'' for purposes of the presumptions of service
connection for such veterans. The bill would require the Secretary to
provide for an independent in-depth medical study to be conducted by
civilian medical entities to determine other diseases that may result
from exposure to depleted uranium. Upon receiving the report of the
study, the Secretary would have to transmit a copy of the report to the
Congressional veterans' affairs committees.
VA does not support this bill because it would create an overly
broad presumption. Although the statutory provision the bill would
amend provides a presumption for diseases associated with exposure to
ionizing radiation, section 3.309 covers many conditions not associated
with radiation exposure, such as chronic diseases, tropical diseases,
diseases specific to former POWs, and diseases associated with exposure
to certain herbicide agents. H.R. 3795 would extend the presumption of
service connection for radiation-exposed veterans to all of these
unrelated diseases.
The scope of H.R. 3795 is also extremely broad in covering veterans
who served in the theater of operations in a conflict in which depleted
uranium munitions were used. Depleted uranium munitions are used
primarily as anti-tank rounds. The bursting radius of those rounds is
much smaller than that encountered in above-ground nuclear tests.
Furthermore, the provision could be read to include ``in the theater of
operations'' servicemembers who served at sea or in airborne operations
whose service occurred far from where these weapons were used. Exposure
to hazards from depleted uranium would be very unlikely, if not
impossible for such servicemembers.
We are developing a benefit-cost estimate for this bill and will
submit it for the record. No additional FTE costs would be associated
with this bill because a minimal impact on workload would be expected.
We estimate that discretionary costs related to the study, based on
previous contracts, would be less than $2 million.
H.R. 4274
H.R. 4274, the ``Gold Star Parents Annuity Act of 2007,'' would
provide a monthly benefit of $125 to parents of servicemembers who lost
their lives while on active duty in certain military operations
described by 10 U.S.C. Sec. 1126(a). If more than one parent is
eligible for the benefit, it would be divided equally among the
eligible parents.
VA honors the sacrifice of the servicemembers who have lost their
lives in the service of their country. VA also recognizes and honors
the supreme sacrifice of Gold Star parents, who have lost a son or a
daughter serving in the Armed Forces. However, VA does not support this
bill because VA already provides a monthly benefit to certain
qualifying parents.
Parents' dependency and indemnity compensation (DIC) is a monthly
benefit that is currently paid to eligible surviving parents of a
veteran who died while on active duty, or after service as a result of
service-connected disability. Parents' DIC is a need-based income-
support benefit.
H.R. 4274 would authorize a small benefit, which would be divided
among eligible parents if there is more than one. The administrative
burden of paying this benefit would be great relative to its size.
Additionally, the bill would provide disparate treatment. Although it
may be appropriate for the Congress to distinguish between combat-
related deaths and other service-related deaths, the requirement that
the servicemember have died while engaged in combat operations and on
active duty fails to acknowledge that some post-service deaths,
particularly in the early years following separation, can be tied
directly to battle wounds and thus creates at least the appearance of
disparate treatment.
Costs for this bill cannot be estimated at this time.
H.R. 5155
H.R. 5155, the ``Combat Veterans Debt Elimination Act of 2008,''
would prohibit VA from collecting all or part of a debt owed to the
United States under any program under the laws administered by VA
(other than a housing or small business program under chapter 37 of
title 38, United States Code) by a veteran who dies as a result of a
service-connected disability incurred or aggravated while serving in a
theater of combat operations in a war after the Persian Gulf War or in
combat against a hostile force during a period of hostilities after
September 11, 2001, if the Secretary determines that termination of
collection is in the best interest of the United States. The amendments
made by the bill would be effective on the date of enactment and would
apply ``with respect to collections of indebtedness of veterans who die
on or after September 11, 2001.''
VA supports the intent behind this bill, but does have a concern
with the effective-date provision. That provision is unclear as to
whether the prohibition on debt collection would apply retroactively to
a debt already collected before the date of enactment or apply only
prospectively. We recommend that the bill be amended to require VA to
refund any amount of a debt of a covered veteran collected after
September 11, 2001, but before the date of enactment.
We estimate that enactment of this bill, if amended as recommended,
would result in additional benefit costs of $5,000 for FY 2009 and a
10-year cost of $50,000.
H.R. 5454
H.R. 5454, would establish a presumption of service connection for
amyotrophic lateral sclerosis (ALS), a rare disease of unknown cause,
for any veteran who develops the disease to a compensable level at any
time after separation from service.
VA does not support this bill. Current evidence does not justify
the establishment of a presumption for ALS. There is insufficient
credible scientific evidence that ALS is caused by service or more
likely to develop in veterans as opposed to the general population.
Although the Institute of Medicine (IOM) found limited suggestive
evidence of an association between the development of ALS and military
service, the IOM clearly indicated that the disease's cause is unknown.
A review of the literature cited seems to suggest that ALS is
associated with vigorous people, as would be found in military service,
but is not unique to the military.
We estimate benefit costs of this bill to be $23.5 million during
FY 2009, $214.2 million over 5 years, and $505.8 million over 10 years.
This bill would minimally affect workload, so FTE costs would be
insignificant.
H.R. 5709
H.R. 5709, the ``Veterans Disability Fairness Act,'' would require
the Secretary to carry out quality assurance activities with respect to
the administration of disability compensation to ensure accuracy and
consistency across different VA offices with respect to whether a
disability is service connected and disability ratings. The Secretary
would be required to retain, monitor, and store data for each claim for
disability compensation, to include: (1) the state the claimant resided
in when the claim was submitted; (2) the Secretary's decision with
respect to the claim; (3) the regional office and individual employee
responsible for evaluating the claim; (4) the results of adjudication;
and (5) such other data as the Secretary determines is appropriate for
monitoring the accuracy and consistency of decisions.
H.R. 5709 would further require VA to conduct reviews and audits,
at least annually, to identify and correct any adjudication
inaccuracies or inconsistencies. The reviews and audits would have to
include a sample large enough to draw statistically valid conclusions.
Additionally, the Secretary would have to consider factors relating to
consistency and accuracy when evaluating adjudication employees. The
bill would require the Secretary to report to Congress, within 60 days
of enactment, on the implementation of this legislation and to include
information on consistency in the annual report required by 38 U.S.C.
Sec. 7734(2).
VA does not support H.R. 5709. VA already has measures in place,
and is implementing additional measures, that address most of the
subjects covered in H.R. 5709. VA has a robust quality assurance
program. Quality reviews are conducted on a statistically valid sample
of adjudicated claims. VA will begin routinely monitoring the most
frequently rated diagnostic codes in FY 2008 to assess consistency of
service-connection determinations and degree of disability assigned for
various disabilities across regional offices. VA conducts regular site
visits at VA regional offices to assess operations for consistency and
accuracy. In addition, a random sample of cases adjudicated by
employees responsible for adjudicating claims is reviewed for quality
at the regional offices. The results of this review represent one
element of employee performance.
Training is an integral part of VA's quality assurance program. The
Center for Naval Analyses reviewed VA's training efforts for the
Veterans' Disability Benefits Commission and was highly complimentary
of VA's training efforts in testimony before the Commission. Also, in a
recent assessment of the Department of Defense (DoD) Disability
Evaluation System, the Government Accountability Office referred to the
VA Compensation and Pension quality review program as a favorable model
for adoption.
Because the bill would not affect benefit entitlement, no mandatory
costs would be associated with it. There would be no additional FTE
costs because the bill would not affect workload, and VA already
maintains a staff to conduct quality and consistency reviews.
H.R. 5954
H.R. 5954 would: (1) establish a presumption of service connection
for any diagnosed disease determined by the Secretary to have an
increased incidence in veterans exposed to a biological, chemical, or
other toxic agent known or presumed to be associated with service
during which the veteran was directly or indirectly subjected to a
chemical or biological warfare test or project under Project 112; (2)
require the Secretary to determine the presumptive period during which
such disease must manifest itself to warrant a presumption of service
connection; (3) establish a presumption of such exposure if the veteran
was subjected to a Project 112 test; and (4) require the Secretary to
notify, under regulations prescribed not later than 180 days after
enactment, all veterans who were potentially exposed to any biological
or chemical agent, simulant, tracer, or decontaminant during Project
112 of the potential exposure.
Further, this bill would require DoD, in consultation with VA, to
submit to Congress, within 1 year after enactment, a report that would:
(1) document the costs, benefits, and challenges associated with
continuing the search for additional Project 112 participants; (2)
provide a full accounting of all information known concerning Project
112 participants; and (3) address other concerns regarding Project 112
held by the VA, veterans, or veterans service organizations.
Project 112 was a comprehensive program initiated in 1962 by DoD to
protect and defend against potential chemical and biological warfare
threats. Project SHAD (an acronym for Shipboard Hazard and Defense), a
component of Project 112, encompassed a series of tests by DoD to
determine the vulnerability of U.S. warships to attacks with chemical
and biological warfare agents, and the potential risk to American
forces posed by these agents. Project 112 also involved similar tests
conducted on land rather than aboard ships.
VA opposes this bill. VA has already contracted for a significant
long-term study concerning the health effects on SHAD participants and
received the report from the IOM. The Secretary has authority to
contract for an additional study if it is deemed necessary. We believe
that enactment of this bill is unwarranted at this time due to the lack
of credible scientific and medical evidence that adequately
demonstrates any statistically significant correlation between
participation in SHAD tests and the subsequent development of any
disease.
DoD continues to release declassified reports about sea--and land-
based tests of chemical and biological materials associated with
Project 112. VA is working with DoD to obtain information regarding the
tests, including who participated, duration, and agents used. DoD
estimates that about 6,000 veterans may have been involved in Project
112/SHAD. To date, DoD has provided VA with the names of approximately
5,000 veterans who participated in the tests. In May 2002, VA began to
contact veterans who participated in Project SHAD about medical care
and benefits to which they may be entitled.
In October 2002, VA contracted with the IOM to conduct a 3-year,
$3-million study of potential long-term health effects of tests
conducted aboard Navy ships in the sixties. IOM's report, ``Long-Term
Health Effects of Participation in Project SHAD,'' was published in May
2007 and found no clear evidence that specific long-term health effects
are associated with participation in Project SHAD.
We are in the process of estimating the costs that would be
associated with enactment of this bill, and we will provide them for
the record.
H.R. 5985
H.R. 5985, the ``Compensation for Combat Veterans Act,'' would
require VA to treat certain veterans as having engaged in combat with
the enemy for purposes of 38 U.S.C. Sec. 154(b), thus permitting the
use of lay or other evidence for proof of service incurrence of a
combat-related disease or injury. The veterans who would qualify for
this treatment are veterans who, during active service with a U.S.
military, naval, or air organization during a period of war, campaign,
or expedition, served in a combat zone for purposes of section 112 of
the Internal Revenue Code 1986, or a predecessor provision of law. In
essence, this bill would equate service in a combat zone with engaging
in combat with the enemy. VA does not support this bill.
Section 112(c)(2) of the Internal Revenue Code 1986 defines
``combat zone'' as any area that the President by executive order
designates as an area in which U.S. Armed Forces are engaging or have
engaged in combat. Section 112 governs the computation of gross income
for tax reporting purposes based upon service and applies to all
veterans who serve in a combat zone regardless of actual involvement in
combat. The executive order designates which geographical areas are
combat zones and the date of commencement of combat activities.
Section 1154(b) of title 38, United States Code, relaxes the
evidentiary requirements a combat veteran must meet to prove service
incurrence or aggravation. The language of section 1154(b) makes it
clear that its purpose is to liberalize the method of proof for claims
based on injuries incurred or aggravated while engaged in combat with
the enemy. This provision recognizes the unique circumstances of
combat, which are not favorable for documentation of injury or illness
because treatment for such injury or illness may be administered in the
field under exigent conditions that do not permit concurrent
documentation. Supporting evidence is often difficult to obtain when a
veteran later files a claim for disability compensation for a combat-
related disability. This bill contemplates that all veterans in a
combat zone are faced with the same difficulty in documenting treatment
for injury or illness. However, the same difficulty does not exist for
servicemembers who, although serving in a combat zone, have access to a
medical facility for treatment and whose treatment would be documented
in service treatment records. The purpose of section 1154(b) was to
recognize the unique circumstance of actual combat.
We cannot estimate benefit costs that would result from enactment
of this bill because there are no data available upon which to estimate
the number of claims for service connection filed by veterans for
disabilities incurred in a combat zone.
H.R. 6032
H.R. 6032 would establish a presumption of service connection for
Parkinson's disease for any veteran who served in the Republic of
Vietnam during a certain period and develops the disease to a
compensable level at any time after separation from service.
VA does not support this bill. The Agent Orange Act 1991, codified
at 38 U.S.C. Sec. 1116, requires that, when the Secretary, on the basis
of sound medical and scientific evidence, determines that a positive
association exists between herbicide exposure and a disease, the
Secretary will issue regulations providing a presumption of service
connection for such disease. The Agent Orange Act further directs that
the Secretary take into account reports from the National Academy of
Sciences.
The IOM of the National Academy of Sciences has consistently
determined that there is insufficient evidence to associate Parkinson's
disease with herbicide exposure. The IOM continued this determination
in its most recent report, ``Veterans and Agent Orange, Update 2006.''
VA believes that it should recognize diseases as presumptively
associated with service only if such association is adequately
established by credible medical and scientific evidence. Such evidence
has consistently failed to demonstrate an association between
Parkinson's disease and herbicide exposure.
We are in the process of estimating the costs that would be
associated with enactment of this bill and will provide them for the
record.
This concludes my statement, Mr. Chairman. I would be happy to
entertain any questions you or the other Members of the Subcommittee
may have.
Statement of Hon. Michael L. Dominguez,
Principal Deputy Under Secretary of Defense for
Personnel and Readiness, U.S. Department of Defense
Mr. Chairman and Members of this distinguished Committee, thank you
for the opportunity to provide views on draft legislation. Our comments
on several of the bills are below.
H.R. 3795, the bill provides that veterans of service in the 1991
Persian Gulf War and subsequent conflicts shall be considered to be
radiation-exposed veterans for purposes of the service connection of
certain diseases and disabilities.
The Department of Defense (DoD) opposes this legislation. This bill
is very broad and assumes any participation in the 1990-1991 Persian
Gulf War with subsequent development of diseases, as specified in
sections 3.309 and 3.311 of Title 38 of the Code of Federal Regulations
(cancers and other diseases) is based on radiation exposure. It
eliminates any requirement for evidence of radiation exposure. More to
the point, the premise that depleted uranium causes a radiation hazard
that is sufficient to cause adverse health effects in humans is
unsupportable. Uranium is a very common naturally occurring heavy
metal, and depleted uranium is 40 percent less radioactive than natural
uranium. There is no evidence that the extremely low radiation levels
emitted by depleted uranium can cause illnesses in humans. There is no
evidence that natural or depleted uranium exposure causes cancer in
humans.
H.R. 5454, the bill establishes a presumption of service connection
of amyotrophic lateral sclerosis (ALS) for purposes of the laws
administered by the Secretary of Veterans Affairs.
DoD opposes this legislation. The scientific evidence does not
support a presumption of service connection of ALS. Although there are
a couple of reports that show a possible association between ALS and
military service, there is currently insufficient evidence to conclude
that ALS is caused by military service. In the general population,
approximately 10 percent of cases are genetic and the causes of the
other 90 percent of cases are unknown. Similarly, the causes of 90
percent of ALS cases in military veterans are unknown. Several research
projects are underway that will determine whether military veterans are
at increased risk for developing ALS, compared with individuals who did
not serve in the military.
H.R. 5954, the bill provides veterans presumptions of service-
connection for purposes of benefits under laws administered by
Secretary of Veterans Affairs for diseases associated with service in
the Armed Forces and exposure to biological chemical or other toxic
agents as part of Project 112.
DoD opposes this legislation. The scientific evidence does not
support a presumption of service connection for any diseases associated
with exposure to biological, chemical, or other toxic agents that
resulted from Project 112 (also frequently called Shipboard Hazard and
Detection--SHAD, although SHAD was only a component of Project 112).
Project 112/SHAD was a series of tests which took place in 1962-73. The
Department of Veterans Affairs requested civilian medical experts in
the Institute of Medicine (IOM) to perform a comprehensive study of the
possible long-term health effects of participation in Project 112. The
IOM study was published in 2007 and concluded that there was no clear
evidence of specific health effects that were associated with
participation in Project SHAD.
In addition, having conducted an exhaustive search for information
on Project 112/SHAD, DoD does not agree that additional archives
searching would result in a more complete documentation. However, DoD
will investigate any new information that may be presented and share
that information with the Department of Veterans Affairs and the
public.
H.R. 5985, the bill clarifies the service treatable as service
engaged in combat with the enemy for utilization of non-official
evidence for proof of service-connection in a combat-related disease or
injury.
DoD opposes this legislation. This provision equates service in a
combat zone with engaging in combat with the enemy for the purposes of
establishing service connection for combat-related diseases or
injuries. While supporting evidence is often difficult to obtain for
disability compensation for a combat-related disability, this bill
provides that all veterans in a combat zone are faced with the same
difficulty in documenting treatment for injury or illness. However, the
same difficulty does not exist for servicemembers who, although serving
in a combat zone, have access to a medical facility for treatment and
whose treatment would be documented in service treatment records.
H.R. 6032, the bill directs the VA Secretary to provide wartime
disability compensation for certain veterans with Parkinson's disease.
DoD opposes this legislation. This legislation would provide a
presumption of service connection for Parkinson's disease for veterans
of the Vietnam War. From 1994 to 2006, the IOM has published seven
exhaustive reports on the possible health effects of Agent Orange and
other herbicides used during the Vietnam War, and another report will
be published during the next year. The IOM has consistently concluded
that there is insufficient evidence for a link between exposure and
Parkinson's disease. Therefore, scientific evidence is lacking to
support a presumption of service connection.
Statement of Hon. Bruce L. Braley,
a Representative in Congress from the State of Iowa
Thank you, Chairman Hall, Ranking Member Lamborn, and Members of
the Subcommittee, for considering H.R. 5985, the Compensation for
Combat Veterans Act, at your hearing today. It is an honor to testify
before you in support of this legislation.
I introduced the Compensation for Combat Veterans Act in May in
order to address a problem faced by too many of our veterans. Today,
combat veterans are required to provide official evidence that they
were wounded in a specific combat incident in order to demonstrate that
their injuries are service-connected. I believe that Congress should
overturn this requirement, and that service in a combat zone should be
sufficient evidence to demonstrate that a veteran received their
injuries in combat.
The Compensation for Combat Veterans Act would clarify that
evidence in a veteran's record of assignment in a combat zone is
sufficient for a veteran to prove their combat service when other
military documents are unavailable. This bill would remove the
documentation barriers that in some cases are preventing combat
veterans from receiving compensation for their disabilities, or which
cause unnecessary delays in providing veterans with the benefits they
deserve.
A law passed in 1941 liberalized the requirements for proof of
service-connection in cases involving veterans who participated in
combat. Under this existing law, veterans who can establish that they
participated in combat do not have to produce official military records
to support their claim that their disabilities or injuries are service-
connected.
However, a Department of Veterans Affairs General Counsel opinion
issued in 1999 requires veterans to establish by official military
records or decorations that they ``personally participated in events
constituting an actual fight or encounter with a military foe or
instrumentality.'' Under this opinion, some veterans are being delayed
or denied compensation for combat injuries because they are unable to
produce official military documentation--like certain medals, unit
reports, or news reports--proving their personal participation in a
specific combat incident.
While the VA accepts certain medals as proof of combat, only a
fraction of those who actually participate in combat receive a
qualifying medal. In addition, making, maintaining, and transmitting
records in combat zones can be difficult and chaotic, and military
records usually do not document actual combat experiences.
Mr. Chairman, I believe that the last thing our wounded veterans
returning home from war should have to do is engage in another battle
with the VA to prove that they were wounded in a specific incident in
order to receive disability benefits. How can the VA conscionably force
a veteran suffering from Post-Traumatic Stress Disorder (PTSD), or from
a physical injury incurred in combat, to track down official proof--
proof that may not even exist, considering the poor records keeping in
combat zones--of their engagement in battle? How can the VA force
wounded veterans to wait indefinitely for help as the VA conducts
research to determine whether the veteran's unit engaged in combat?
This requirement is just one more example of an unnecessary
bureaucratic barrier, another piece of arbitrary red tape, which our
wounded veterans must face. I am especially concerned with this
bureaucratic hurdle because, as we saw at the Oversight and Government
Reform Committee hearing at Walter Reed last year, the layers and
layers of VA and DoD bureaucracy directly contributed to the systemic
breakdown and the mistreatment of veterans there. Unless we start to
peel away these bureaucratic layers, I'm afraid we are in danger of
repeating the shame of Walter Reed and denying veterans the treatment
and benefits they deserve.
Indeed, unnecessary red tape and unnecessary delays in receiving
benefits continue to plague veterans all over the country, and continue
to be identified by veterans and those who work with them as one of the
most significant problems facing returning veterans today. The
astounding number of backlogged VA benefits claims--currently over
648,000--is evidence of this problem. I am concerned that this number
is only going to increase as more veterans return from the wars in Iraq
and Afghanistan unless we address some of these paperwork and
documentation problems. The Compensation for Combat Veterans Act would
do just that: VA Regional Offices have estimated that the passage of
this bill would speed up their claims processing by weeks.
David Woods, the Director of Veterans Affairs for Scott County,
Iowa, who is testifying before the Subcommittee today, estimates that
he has helped 75-100 injured veterans who have had problems proving
that they were injured in specific combat incidents. This includes
veterans returning from Iraq and Afghanistan, as well as Vietnam
veterans experiencing PTSD triggered after several decades by the
current wars. As David has said, soldiers engaged in combat are often
from several different units and do not know who is there fighting
along with them when a battle breaks out. Soldiers engaged in combat
are focused on survival--not documenting where and when the battle is
taking place.
My office has also worked with at least one veteran who has
experienced this problem. This veteran came to my office last August
asking for assistance with his service-connected disability claim for
his wounded shoulder and other injuries. Though the VA treated his
shoulder, since his medical records from Iraq are missing, the VA won't
approve service-connection. This veteran has served two separate
deployments in Iraq, and I believe that it is unacceptable that he is
being denied the benefits that he deserves.
That is why I believe it is so important to pass the Compensation
for Combat Veterans Act. My bill would overturn the VA General Counsel
precedent opinion, and allow for utilization of non-official evidence
as proof of in-service occurrence for establishing service connection
of combat-related diseases and injuries. This bill would eliminate the
requirement for further evidence in cases in which a veteran can
demonstrate service in a recognized combat area, alleges disabilities
related to their service in that combat area, and has a disease or
injury consistent with the circumstances, conditions, or hardships of
their service in that combat area. This bill would lower the
evidentiary standards for veterans suffering from physical injuries, as
well as from mental wounds like PTSD or Traumatic Brain Injury, the
hidden and hallmark wounds of the wars which often do not materialize
for months after a veteran has returned home.
Again, thank you for allowing me to testify in support of the
Compensation for Combat Veterans Act today. I hope that the
Subcommittee and full Veterans Affairs' Committee will act quickly to
move this important legislation forward to ensure that combat veterans
receive the benefits they deserve in a timely manner.
Statement of Kerry Baker,
Associate National Legislative Director, Disabled American Veterans
Mr. Chairman and Members of the Subcommittee:
On behalf of the 1.3 million members of the Disabled American
Veterans (DAV), I am honored to present this testimony to address
various benefits bills before the Subcommittee today. In accordance
with our congressional charter, the DAV's mission is to ``advance the
interests, and work for the betterment, of all wounded, injured, and
disabled American veterans.'' We are therefore pleased to support
various measures insofar as they fall within that scope.
H.R. 1197
The ``Prisoner of War Benefits Act of 2007'' (H.R. 1197),
introduced by Congressman Bilirakis in February 2007, would provide
improved benefits for veterans who are former prisoners of war (POW).
Specifically, H.R. 1197 would repeal the minimum period of internment
for presumptive service connection for diseases associated with POW
status. The bill would also add type 2 Diabetes and osteoporosis to the
list of diseases presumptively associated with POW status. The DAV has
a standing resolution to support the expansion of benefits for former
POWs; therefore, we support this bill.
The bill also authorizes the Department of Veterans Affairs (VA) to
establish additional diseases as presumptively related to a veteran's
POW status. Such authorization instructs the VA to establish a new
disease as presumptively related to POW experiences whenever credible
evidence for the association is equal to or outweighs the credible
evidence against the association. The DAV feels this criteria is very
fair considering that a disease may not be considered presumptive
unless evidence as a whole suggests no relationship and that such
evidence is not outweighed by evidence that does suggest a
relationship. The Nation's former POWs have earned no less.
H.R. 3008
The ``Rural Veterans Services Outreach and Training Act'' (H.R.
3008), introduced by Congressman Wu in July 2007, is meant to improve
services to veterans residing in rural areas. The bill proposes to
improve outreach and assistance to veterans, their dependents, and
survivors through training of rural county veterans' service officers
(CVSOs). The bill proposes to do this by making competitive grants to
provide financial assistance to state departments of veterans affairs
wherein the grants are determined by the Secretary of Veterans Affairs
(Secretary) but shall not exceed $1,000,000.
The DAV is concerned that providing Departmental funds to train
CVSOs may not be the best use of such funds. Nonetheless, the DAV has
no resolution on this issue and we therefore take no position on the
bill.
H.R. 3070
The ``Disabled Veterans' Caregiver Compensation Act'' (H.R. 3070),
introduced by Congressman Peterson in July 2007, would authorize
additional compensation, in the amount of $234.00, to be paid to
certain veterans in receipt of compensation for a service-connected
disability rated totally disabling for whom a family member dependent
on the veteran for support provides care. This extra compensation would
be paid ``[i]f and while rated totally disabled and in need of regular
aid and attendance and while unpaid aid and attendance is provided by
an adult family member who is dependent upon such veteran for support.
. . .''
The DAV supports this bill--we applaud it. However, clarification
is needed. Title 38 defines ``child'' and ``parent'' as they relate to
various veterans' benefits. Title 38 does not define ``dependent'' for
benefits administered by the Secretary. Without such a definition, at
least concerning the amendments made by this bill, it will be unclear
who qualifies for this benefit. For example, an adult child caring for
a veteran described by this bill may qualify as an ``adult family
member'' but still not qualify as ``dependent upon such veteran'' if
the child were not financially dependent on the veteran. Such a child
could not qualify as a dependent, even if he/she had to relinquish
employment in order to care for the parent because the child may no
longer qualify as a ``child'' for VA purposes.
We do not believe the bill's intent is to exclude those in the
above scenarios, as well as others. Therefore, while we fully support
the bill, we request the bill be amended to properly define who does
and does not qualify for the benefit provided by the bill.
Additionally, the amount of compensation listed herein ($234) is
equal to the amount of compensation listed in section 1115 payable to a
veteran with a spouse in need of aid and attendance. If this figure is
no coincidence, which we do not believe to be the case, we must note
that $234 is the figure for 2002. We asked that the bill be amended to
reflect the current year's level of compensation.
H.R. 3795
The ``You Were There, You Get Care Act of 2007'' (H.R. 3795),
introduced by Chairman Filner in October 2007, would provide that
veterans of service in the 1991 Persian Gulf War and subsequent
conflicts shall be considered to be radiation-exposed veterans for
purposes of service connection for certain diseases and disabilities,
and for other purposes. This bill would provide presumptive service
connection for any ``disease that is covered under section 3.309 or
3.311 of title 38 of the Code of Federal Regulations and any other
disease found by the Secretary to result from exposure to depleted
uranium or the by-products of the burn-off that occurs when a depleted
uranium munition penetrates a target. The DAV supports this bill.
Those veterans covered by this bill are those that served during
the Persian Gulf War or any subsequent conflict in which depleted
uranium munitions are used, if that service is in the theater of
operations of that war or conflict or involved the clean-up or
servicing of vehicles or equipment that had been in such a theater of
operations. The DAV does not have a standing resolution directly on
point with this bill, we do however have resolutions calling for the
support of enhanced benefits for Persian Gulf War veterans suffering
from diseases associated with their service. Therefore, the DAV fully
supports this bill.
H.R. 4274
The ``Gold Star Parents Annuity Act of 2007'' (H.R. 4274),
introduced by Congressman Walsh in December 2007, would provide for the
payment of a monthly stipend to the surviving parents (known as ``Gold
Star parents'') of members of the Armed Forces who die during a period
of war. The DAV has no opposition to this bill.
This bill would require the Secretary to pay a monthly pension to
each person who has received a gold star lapel button under section
1126 of title 10 as a parent of a person who died in a manner described
in that section. The total amount of payment to a Gold Star parent
would be $125. If there is more than one eligible parent, the total
amount would be divided equally among the eligible parents.
While the DAV has no opposition to this bill, we do not believe
that $125, or $75 dollars each for two parents is adequate. These
amounts cannot begin to honor the depth of a parent's sacrifice when
their child, perhaps their only child, is lost forever on a distant
battlefield. Death on the battlefield is unquestionably the greatest
sacrifice a servicemember can make for his or her country, but it is
also the greatest sacrifice that a parent can make. Therefore, while we
respect the intent of this bill and thank Mr. Walsh for its
introduction, we respectfully request the monetary amount described
herein be substantially increased.
H.R. 5155
The ``Combat Veterans Debt Elimination Act of 2008'' (H.R. 5155),
introduced by Congresswoman Shea-Porter in January 2008, would prohibit
the Secretary from collecting certain debts to the United States in the
case of veterans who die as a result of a service-connected disability
incurred or aggravated on active duty in a combat zone. The DAV has no
resolution on this issue, which is essentially outside our mission
scope. Therefore, we take no position on this bill.
H.R. 5448
The ``Full Faith in Veterans Act of 2008'' (H.R. 5448), introduced
by Congressman Allen in February 2008, would seek to improve the
disability compensation evaluation procedures for veterans with post
traumatic stress disorder and to improve the diagnosis and treatment of
post traumatic stress disorder. The DAV has no opposition to this bill;
in fact, we are on record as staunch supporters of a similar bill, H.R.
5892.
H.R. 5892 accomplishes many of the same goals as this bill and has
already been moved out of Committee and into the full House. H.R. 5892
is also more comprehensive than H.R. 5448, while achieving the same
goals as this bill. Because of this, and even though we do not oppose
this bill, we respectfully request that any resources that Congress
would otherwise spend on this bill be diverted to support the passage
of H.R. 5892.
H.R. 5454
Congressman Brown introduced H.R. 5454 in February 2008. This bill
would establish a presumption of service connection of amyotrophic
lateral sclerosis for purposes of the laws administered by the
Secretary. Essentially, this bill would amend section 1112 of title 38,
United States Code, to provide for a presumption of service connection
for amyotrophic lateral sclerosis when developing to a 10 percent
degree of disability at any time after service. Although the DAV has no
resolution on this issue, because of its positive impact on disabled
veterans and their dependents, as well as the higher prevalence of this
disease among the veteran population, we support this bill in full.
H.R. 5709
The ``Veterans Disability Fairness Act'' (H.R. 5709), introduced by
Congressman Space in April 2008, would require the Secretary to carry
out quality assurance activities with respect to the administration of
disability compensation. In order to carry out the quality assurance
program under section 7731 of title 38, United States Code, with
respect to the administration of disability compensation, this bill
would require the Secretary to ensure accuracy and consistency across
different offices within the Department of the treatment of claims for
disability compensation, including determinations with respect to
disability ratings and whether a disability is service connected.
For each disability compensation claim, this bill would require the
Secretary to track and monitor the following: (1) The state in which
the claimant resided when the claim was submitted; (2) the decision of
the Secretary with respect to the claim; (3) the regional office and
individual employee of the Department responsible for evaluating the
claim; (4) if the claim was adjudicated, the results of such
adjudication; (5) the state of the claimant's residence; and (6) such
other data as the Secretary determines is appropriate for monitoring
the accuracy and consistency of decisions with respect to such claims.
Once compiled, the Secretary would be required to use this information
to conduct annual reviews to correct any inaccuracies or
inconsistencies in disability ratings and the adjudication of claims
for disability compensation. Such reviews and audits shall evaluate
disability ratings and claims adjudication by regional office and by
the employee responsible for each such rating or adjudication
The DAV has long advocated for enhanced quality assurance and
oversight of VA's disability claims processing system. We therefore
support this bill and applaud Mr. Space for its introduction.
H.R. 5954
Congressman Thompson introduced H.R. 5954 in May 2008. If enacted,
this bill would provide veterans with presumptions of service
connection for purposes of benefits under laws administered by the
Secretary for diseases associated with service in the Armed Forces and
exposure to biological, chemical, or other toxic agents as part of
Project 112. This bill is one that all disabled veterans who were
unknowingly harmed by military experiments and wrongfully denied
disability benefits to which they were legally entitled should
celebrate.
This legislation will only be successful if the Department of
Defense (DoD) releases the names of all participants of these military
experiments, many of which may not even be aware of their involvement.
For this reason, the DAV is pleased that this bill requires the DoD to
release the information vital for the success of this bill. Without
such a requirement, those affected by these unthinkable experiments
will continue to be locked out of a system otherwise designed to
provide the help this bill delivers.
Since 2003, the DoD has stopped actively searching for individuals
who were potentially exposed to chemical or biological substances
during Project 112 tests, but have not provided any basis for that
decision. In 2003, the DoD reported it had identified 5,842
servicemembers as having been potentially exposed during Project 112,
but also indicated that it would cease searching for additional
individuals. In 2004, the government Accountability Office (GAO)
reported that the DoD did not exhaust all possible sources of
information.
Since June 2003, however, non-DoD sources--including the Institute
of Medicine--have identified approximately 600 additional names of
individuals who were potentially exposed during Project 112. This fully
supports the proposition that the DoD's actions were completely
arbitrary. Until these issues are addressed, veterans will remain
unaware of their potential exposure, and this monumental injustice of
experimentation on U.S. servicemembers will continue to go unanswered.
Congress must mandate that the DoD live up to its obligation of
identifying every single veteran that may have had even the smallest
potential of exposure. This bill is a large step in the right direction
and the DAV supports it.
H.R. 5985
The ``Compensation for Combat Veterans Act'' (H.R. 5985),
introduced by Congressman Braley in May 2008, would clarify service
treatable as ``service engaged in combat with the enemy'' for
utilization of non-official evidence as proof of service connection in
a combat-related disease or injury. The DAV supports this bill;
however, we suggest amendments. This legislation establishes that a
veteran who ``during active service . . . served in a combat zone for
purposes of section 112 of the Internal Revenue Code of 1986, or a
predecessor provision of law, shall be treated as having engaged in
combat with the enemy in active service for purposes of that paragraph
during such service in that combat zone.'' The legislation as currently
written would allow, for example, an Iraqi War veteran who only served
in Bahrain and was consequently never in danger of being exposed to
combat, the same consideration as an Iraqi War veteran who served
inside the combat theatre of operation.
We therefore suggest an amendment to this legislation that would
still consider a class of veterans as having been exposed to combat,
but suggest that those veterans with service inside the borders of the
combat theatre of operation receive such consideration, such as those
serving inside the borders of Iraq, Afghanistan, Vietnam, etc.
H.R. 6032
Congressman Filner introduced H.R. 6032 in May 2008. The bill would
direct the Secretary to provide wartime disability compensation for
veterans who served in the Republic of Vietnam and who have manifested
Parkinson's disease to degree of 10 percent or more. The DAV is
certainly not opposed to enhancing benefits for veterans who served in
the republic of Vietnam. However, currently we are unaware of
scientific evidence suggesting a positive association between
Parkinson's disease and exposure to herbicides. Therefore, the DAV
takes no position on this bill. If, however, such scientific evidence
becomes available, or we are otherwise made aware of its existence, we
will fully support this legislation.
Mr. Chairman, this concludes my testimony on behalf of DAV. We hope
you will consider our recommendations.
Statement of Susan R. Frasier,
Albany, NY (Disabled Veteran), on behalf of
Fort McClellan Veterans Stakeholders Group
Thank you Mr. Chairman, for allowing us to make a brief appearance
in writing for the record, and to speak on some of the breakthrough
bills which appear on your docket today. Our remarks will be directed
to H.R. 5954 which provides a long awaited justice to our military
brothers of the Project 112 ship tests during the Cold war Era, and
also to H.R. 3795 for the veterans of the Gulf War.
I am the lead activist for the Fort McClellan Veterans Stakeholders
Group. We formed this group in 2003 to advance our own pursuits for
legislation and justice inside the VA disability system. We are mostly
medical and disability patients who have served at Fort McClellan,
Alabama from 1955 to 1978. We hold the Cold war Service Medals issued
under the Clinton administration from years past. We do consider
ourselves to be chemical exposure victims from our service at the base,
and we can speak in verification about the ordeal the current VA
disability system poses to any new and incoming Veterans who identify
themselves as known or suspected exposure cases, regardless of the
source.
We applaud, endorse, and support the victories which are
represented in your bills today by H.R. 5954 and H.R. 3795. Those
exposure groups have worked long and hard along side our own group, to
receive this day of justice in their names. The tests of Project 112
and its loosely related counterpart, more commonly referred to out here
in our Veterans arena as the Edgewood tests, were in some ways a freak
of the times. We can only wonder what the military authorities were all
thinking when they subjected these brave volunteers to various forces
of contamination and then walked away without providing them with
adequate followup reviews for medical tracking or to give them
prioritized disability standing in the VA medical system.
For our Gulf War counterparts, they too have been put through an
ordeal that was prolonged, unnecessary, and preventable if only the VA
had a working ``rapid response'' system in place to activate temporary
support services while their Presumptive statuses were pending.
The simple fact that it requires an act of Congress to rescue
verified contamination medical patients inside the current structure of
the VA disability system, speaks volumes about the ordeal that so many
of us have been put through.
While we are relieved, happy, and gratified that H.R. 5954 has
finally arrived for our military brothers of Project 112, we caution
that the rest of the Edgewood test population still should be addressed
by separate legislation, and when that happens, our group will then
exert a vested interest in that outcome too.
Fort McClellan, Alabama from the years 1955 to 1978, also
represents a freak of the times, and poses a new and unique situation
to this legislating body of Congress. It is a situation which has never
before been seen in the history of veterans disability claims. During
the same and simultaneous time span of years, Fort McClellan was not
only a part of the Edgewood series of open air chemical tests on the
grounds of the base itself, but also, the same base was surrounded by a
massive, PCB contamination zone by the nearby Monsanto chemical factory
of it's day in our recreation district of downtown Anniston, Alabama.
The PCB zone contaminated the air, the water, and the soil of much of
the surrounding region leading up to the base, even though today's
reports from the Environmental Protection Agency only addresses the
modern day concerns and tests of the water and soil.
The rate of spew from the broken Monsanto air stacks, based on our
computations made from the original notes of the Monsanto pollution
engineers back in the day, amounted to over 2,000 tons per month
released into the air back in the day. Then in addition to that, the
EPA has estimated the cloud cover from that spew to have an extended
overhead smog life of 10 days in lingering. This is to say that the
thousands of pounds of PCB's that spewed into the air on any 1 day,
also remained overhead in that same region for yet another 10 days in
lingering before releasing and dispersing out into the general
atmosphere away from the geographic location. Then this overhead
lingering was added into by yet more spew.
Simultaneously, and without the knowledge of the nearby Monsanto
disaster that was in the works, persons assigned to the Edgewood Cold
war Era tests at Fort McClellan were conducting open air chemical tests
on the base itself. These tests were done with inadequate attention
applied to the protection of those volunteers who were actually in the
tests, and with no protection whatsoever to those of us who were at
other locations on the base and not involved in the tests. This was the
time of the Vietnam War training maneuvers, which included Pentagon-
mandated gashouse training which involved the removal of face masks
inside of active (CN) and (CS) gas discharges so that we could be war
certified in completion of our boot camp training.
We have contended that anyone of these exposure sources, or any
combination of them in the hereafter, may be the causation of our
modern day disabilities and diseases. We may actually be the very first
known medical population to enter the military and VA system to declare
ourselves as a ``bystander'' exposure population since we never knew
the cause of either of these contamination scenarios.
So you can see here the similarity of concerns and experiences that
we bring to the legislative table when offering up our support and
sympathy to our Project 112 military brothers and our counterparts of
men and women from the Gulf War.
The VA has been unresponsive to all of these exposure populations
up until today, so it brings us a great sense of hope and celebration
today to see with our own eyes, this day of victory and justice which
is embodied in your bills of H.R. 5954 and H.R. 3795.
The Department of Veterans Affairs should undergo massive
reorganization to position themselves for the future to serve and
support all hazardous exposure military veterans, regardless of the
source of their exposure. The current VA system is broken beyond repair
and sadly, there is not even a showing of interest in repairing it
whenever we have approached Washington VA officials for resolve.
The VA uses deprivation of services as the first course of action
whenever they are approached by a new population of veterans who are
suspecting themselves to be hazardous exposure medical patients.
Without intervening legislation from Congress, their mistake will not
likely be fixed. The VA has no understanding at all of the meaning of
``emergency response.'' They will stand around in a spirit of inaction
and delay, and literally allow veterans to die or have their hands
forced into suicide from the prolonged suffering they endure, rather
than to eat the embarrassments of correction and apology for their
bureaucratic mistakes.
At the Fort McClellan contamination zone, the veterans who served
there are medically matched to the nearby civilian population, and yet
even with this stunning development to our advantage, the VA holds onto
their delay practices, their deprivation of services, and their no
assistance to our service group as medical patients.
In some ways, Project 112 and the related Edgewood tests are a
symbol of what is also wrong at the VA. All of these matters are an
outcome of excessive proofing requirements gone amuck. There reaches a
point in most rational acts, where relentless questioning, unending
verifying, and proofing above and beyond the norms of medical
scenarios, (and the relentless demanding of the same), crosses a line
beyond the normal limits of proper reason and travels straight over
into a dark side where most of us would never go. There are people in
this world who will spend all of their days questioning life itself:
but that does not mean that the rest of us all have to go along for the
ride.
The VA requires individual medical patients to shed themselves of
their hospital standing, and become mini-agencies in their own name to
prove up, answer up, comply up, and provide the tonnage of science,
medical, classified, unclassified, military, unmilitary, hospital and
even childhood documents just to prove that which every other rational
American in this country can blatantly see with their own eyes as true.
We say, that this all has to stop, in the name of saving the lives of
Veterans. Proofing of disease and disability, at the level of extremes,
excessiveness, and over the top--even when the same logical conclusion
is as plain as day to everyone else who reviews a veterans case, is
causing the premature deaths of our veterans and it is causing them to
die with no service connected benefits in place at all.
Lack of information, concealment of information, and especially the
absence of official NOTIFICATION to Veterans who may have been exposed
to hazardous sources, wreaks havoc throughout the entire chain of
process in both the VA and the Social Security systems. Veterans are
first not officially notified of their exposure circumstances, and then
are also burdened with elaborate and complicated ``nexus theories'' to
succeed either in their individual disability claims or their pursuits
for patient class recognition, which is known in the VA system as
Presumptive Service Connected statusing.
Official notification to Veterans who have come into contact with
any potential contamination source during their military service, must
be integrated into all legislation and policy changes at the VA because
it is crucial information that we have to pass along to our caregivers.
It is vital deciding information that a practicing physician weighs
upon during the moment of diagnosis for these veterans. So notification
must be treated equal in importance to all other features of rescuing
hazardous exposure veterans at the VA.
The VSO's do complicate this ordeal situation even further for us.
Instead of taking on the system to force the VA to reorganize
themselves into an ``emergency response'' program to intake and serve
these exposure veterans, the VSO's force veterans to endure years of
process to comply with the wholly malpracticed systems which the VA
currently has in place.
I have fired VSO's one by one in my own case for this very reason.
Furthermore, VSO's only provide case-in-a-box assistance for claims.
Claims which are far more complicated, and not as cut and dried as
the run of the mill, case-in-a-box, which are presented to them, are
simply refused assistance by the VSO's due to complexity and their
inability to either comprehend the details of the case, or their
inability to construct fast and simple workarounds to the barriers put
up by the VA. Also, if they do accept the case for VSO handling the
veterans are subordinated to unqualified and incompetent case people
who are in over their heads and don't know it. In the end, these
exposure cases in some cases, not always, remain unassisted by VSO's.
We have repeatedly gone out to VSO's to obtain help for our Fort
McClellan advocacies only to have the door slammed in our faces with
either a wall of silence, (much like what the VA does), or a lousy
``thank you for sharing'' letter to facilitate the VA's agenda of delay
until death. I am almost 60 years old and mobility impaired with
muscular disease and yet even identifying myself with that, VSO's have
sided with the nonsense processes of the VA and not with us.
We consider ourselves to be holding matching and textbook disease
patterns to be commonly recognized markers held in all other chemical
exposure populations. But it is only the VA who stands around spinning
its wheels on process and burdening us with delay.
Among the list of those refusing to help us as VSO's includes DAV,
American Legion (Albany & Washington, DC), VFW, the WAC Veterans
Association, Vietnam Veterans of America (the Womens Committee) the
National Veterans Legal Services Corporation and the Veterans Pro Bono
Consortium. Among those who have refused assisting us at the VA
includes Dr. Mark Brown, Irene Trowell-Harris, the Center for Women
Veterans, Comp & Pen, and the VA Secretary's Office himself. At the
Dept. of Defense, the Office of Health Deployment sent us directly to
the VA and would not talk to us any further after passing us to VA
hands.
Among other things, the VA also forces medical patients to
``incorporate'' as non-profit corporations just so they can obtain
legislative or medical recognition as a patient group class. We say for
the record that we are opposed to such practices and insist here before
you today, that these larger systemic issues of the VA be mandatorily
halted in the future. To say to a body of medical patients that their
only hope of advancing medical assistance is to form a corporation and
become a company is just plain nonsense and is contrary to the
treatment advisory of licensed medical practitioners.
The Veterans Disability Benefits Commission of 2007, in their
report to Congress in Chapter 5, has found in our favor as medical
patients and has found against the practices of the VA. In combination
with the Institute of Medicine and the Center for Naval Analysis, they
have concluded that the Fort McClellan Veterans, whether involved in
Edgewood tests or by their exposures to the Monsanto PCB contamination,
should receive their day of legislative justice along with our
counterparts represented in the bills before you today. They have also
concluded that the VA's current process for Presumptive Service
Connected statusing, should be wholly revised and undergo massive
correction. Our Stakeholders Group did participate in the VDBC hearings
and we gave our endorsements to these findings and conclusions when
those topics came up for a floor vote by them. We implore upon you now
to please change the VA presumptive system.
There are 2 simple questions to be answered in all of this as I
present it to you today:
How much is ``enough'' for VA medical patients to have to endure
without any assistance or services?
And also,
Why do individual medical cases have to endure excessive and over
the top proofing requirements in exposure scenarios when the Dept. of
Justice has already litigated cleanups on behalf of the Environmental
Protection Agency for the nearby civilian population?
These are fair questions to know and I bring them to you today in
the name of our Stakeholders Group.
I am not the U.S. Department of Susan R. Frasier, so why is the VA
treating me as if I am a well-funded, fully staffed, and mobilized
government agency without any health impairments?
The Duty To Assist clause in the 38 CFR is also a complete disaster
for us. All it does is allow the VA to obtain documents which actually
verifies our cases, (without us ever seeing those documents first), and
then gives the VA (not the veteran) the litigating advantage to turn
around and use those documents against us to further deny the cases. In
other words, if there is a mistake in the papers which the VA
retrieved, then the individual medical patient is blamed for that
mistake.
In my own case, VARO Manhattan has sought to blame me personally
for the fact that the Monsanto contamination zone in Alabama was never
made publicly known until the late nineties. It is very much a matter
of record that I was denied my 36 year old disability backlogged case
because the Army failed to show in my hospital records that I was
exposed at the Monsanto chemical zone, even though I had sent alternate
information proving to the VA that the contamination was in the air
during my army service.
All of official Washington appears to be unanimous in their voices
that the VA systems of now are in dire need of change and correction.
The VA has possessed the VDBC Commission report to Congress since
October of 2007, and they have possessed Chapter 5 specifically since
January 8, 2008 when I hand delivered it to the VA Secretary's Office
in Washington. And yet here we are 5 months later with no assistance
and no change and no legislation from the VA Secretary to this very
minute.
Congress must look at the VA claims system with new eyes as if you
are riding in a helicopter overhead to see the big picture.
In medical environments, there reaches a point where excessive and
unnecessary process must be set aside in the name of good medicine and
fair justice.
The proofing and evidencing requirements that we are burdened with
as medical patients in the VA are extreme, excessive, over the top, and
used only for purposes of delay and the causation of our premature
deaths. It is done to literally stress and strain a genuinely sick
veteran straight into his or her early grave with upset, despair, and
relentless continuation in the scourge of poverty. These are inhumane
practices which are done for the purpose of gaining legal advantage in
a VA-sponsored disability litigation environment, and we call for its
swift and decisive end. No other hazardous exposure veteran should have
to endure what all of us have been forced to endure at the hands of the
VA.
We send our love, our celebration, and our salutes, to our military
brothers of Project 112 and to our counterparts of the Gulf War era.
Their ordeal and odyssey is now over and not a minute too soon either.
We share in their important victory.
We thank this Congress today, and to all who contributed to the
development of H.R. 5954 and H.R. 3795 for the wisdom and rescue that
both of these bills hold. We ask that you include ``notification to
veterans'' in bills such as these in the future, to mandatorily require
the VA to issue a letter and make an appropriate outreach effort to
advise effected veterans that they have served in a potential
contamination area. This notification is vital to the family
information of those medical patients who are affected by contamination
scenarios.
And we call upon Congress to continue its important work on these
matters of intervention, correction, and emergency for all other
remaining hazardous exposure patient groups, including the Fort
McClellan Veterans, who remain hopelessly trapped in a VA system that
is broken, uncaring, and unserving to all who identify themselves as
potential new exposure cases.
Also Signed in Support, The Following Members of our group:
Carolyn Tyler--Wisconsin
Kathy Warren-Miller--Texas
Sandra Ashley--Washington
John Snodgrass--Alabama
Nancie Smith--Florida
Ellen O'Neill--Ohio
Carolyn Arnold--Ohio
John Kamps--Texas
Janie Lehman--Pennsylvania
William Brawley--North Carolina
Wanda Seay--California
Nancy Gower--Indiana
The remaining members of our group wish to remain anonymous.
Statement of Commander Norman C. Lachapelle, MSC, USN (Ret.),
Administrator, Bureau of Environmental Health/Emergency Regional
Response, Memphis and Shelby County Health Department, TN
Chairman Filner, Ranking Member Buyer and Distinguished Members of
the Committee. My name is Norman C. Lachapelle and I live in Memphis,
Tennessee. I am a retired Commander, Medical Service Corps, U.S. Navy
and presently Administrator, Bureau of Environmental Health/Emergency
Regional Response Coordinator with the Memphis and Shelby County Health
Department in Tennessee.
I received orders to Project SHAD Technical Staff on board USS
Granville S. Hall (YAG-40) in May 1965. My duty assignment was senior
microbiologist and later technical operations officer charged with
overseeing the microbiological and chemical functions in support of
Deseret Test Center (DTC) SHAD tests. I served in that capacity until
1970 interrupted by a 12-month deployment in Vietnam in 1967.
In addition to the Division of five (5) light Tugs as described by
the officer in charge's testimony, the technical staff of SHAD
consisted of experienced Navy microbiologists, hospital corpsmen,
laboratory technicians, gunners mate, meteorologists and photographers.
This group was responsible for:
Preparing and calibrating air monitoring equipment used
on the five (5) Light Tugs that served as aerosol sampling platforms
during open-air sea tests conducted with biological and chemical
simulant released agents.
Conducting quality control of ``munitions'' i.e.,
concentration of agent slurry used for aerosol dispersal from military
jet aircraft.
Analyzing test samples collected from Light Tugs for
quantitative and qualitative microbiological evaluations.
Preparing a summary of raw laboratory qualitative and
quantitative analytical results and data submitted to DTC Test Director
after the completion of each test trial. These data revealed the
concentration of agents collected in the Light Tug laboratories after
each test trial.
For the most part, technical staff participants were informed of
the nature of the tests, standard operating procedures and trained in
precautionary safety techniques using best available practices in the
1960's. In retrospect, based on my experience with DTC-SHAD sea and
land base tests, more stringent safety measures should have been
reinforced involving so called ``harmless'' simulants such as
Escherichia coli (E-Coli) and Serratia marcescens (SM) which are now of
medical concern and no longer used by military in biological aerosol
testing. Most disturbing is the fact that in 1950 the Army sprayed SM
off the Coast of San Francisco, and shortly afterwards patients at
Stanford University Hospital began appearing with Serratia marcescens
infections. This should have been a wake up call on the use of SM and
other biologicals as simulants.
Bacillus globigii (BG) was used as a simulant in the majority of
DTC tests. However, BG, as reported in the Institute of Medicine (IOM)
long-term health effects of participants in Project SHAD study report,
is now considered a pathogen for humans.
Of great concern was the application of beta-propiolactone (BPL)
disseminated as a mist to decontaminate the interior of ships including
the Light Tugs. The procedure involved sealing the vessel after the
crew was evacuated and releasing the BPL from an electrical vaporizer
for a period of time sufficient to destroy microorganisms. To my
knowledge the concentration of BPL was not recorded or the testing of
the interior spaces for residual BPL, to ensure safe re-entry. The
International Agency for Research on Cancer (IARC) regards beta-
propiolactone as a possible Carcinogen and cautions that a single dose
of exposure is enough to pose a significant risk of cancer.
It is important to mention that high level DoD officials testified
at a Senate Armed Services Hearing in 2003 that DTC test records
indicated that sailors were vaccinated against Paternella tularensis
(Tularemia) and Coxriella burnetti (Q-Fever) and that the Army had
vaccines against those agents. Neither of these vaccines were FDA
approved and considered experimental vaccines. To my knowledge, a
medical followup on the health status of the SHAD participants that
were inoculated was not conducted and the type and dosage of the
vaccine were not entered in their medical records.
Regretfully, all information and data about SHAD tests remained
classified until 2001 when DoD began sharing some declassified DTC test
information with Veterans Affairs. SHAD veterans were certainly at a
disadvantage during this time, i.e., over 40 years post termination of
Project SHAD in not having this information available when being
evaluated for proper health care. It is of great value and help for
attending physicians to know as much as possible about concentrations
of hazardous materials that their patients have been exposed to.
It was a privilege and honor to have served with shipmates that
were unquestionably dedicated in accomplishing the dangerous and highly
classified mission of SHAD.
The many Project 112/SHAD participants, who unselfishly and
willingly exposed themselves to hazardous biologicals and chemicals,
oftentimes with minimum personal protection, deserve the highest level
of quality healthcare that this government can provide.
I join the many Project 112 and SHAD Veterans in expressing a
heartfelt appreciation for all the hard and consistent work that
Congressman Mike Thompson has done in our behalf and for Congressman
Rehberg for joining the task.
I thank Chairman Filner, Ranking Member Buyer, and Members of the
Committee, and herein respectfully request that H.R. 5954 be moved from
Committee to the Floor of the House with the recommendation for
approval.
Statement of John A. Scocos,
President, National Association of State Directors of Veterans Affairs,
and
Secretary, Wisconsin Department of Veterans Affairs
On behalf of the National Association of State Directors of
Veterans Affairs, this letter is to express our strong support for the
efforts of the U.S. House Committee on Veterans' Affairs and its work
in advancing bills of great importance to current, past, and future
generations of veterans.
We appreciate you holding this important Committee hearing on these
many issues. Our positions on these bills are as follows:
H.R. 1197--Prisoner of War Benefits Act
We support an expansion of presumptive service-connection benefits,
liberalizing the requisite period of internment, and updating the
determination of such presumption for former prisoners of war.
H.R. 3008--Rural Veterans Services Outreach and Training Act
We support H.R. 3008 only if it is substantially amended as
follows. The current language of H.R. 3008 is an excellent starting
point for continuing a growing dialog on the need for expanded outreach
to our Nation's veterans, though it does not yet reflect the benefits
and service delivery system of the majority of the states. We strongly
support the creation of a statutory definition of outreach that ensures
a systematic, proactive approach, and we support the definition of
outreach as contained in H.R. 3008, which appears to mirror the
language contained in S. 1315 as recently passed by the U.S. Senate and
now awaiting House action. We also strongly support the creation of a
federal grant program to the States for the provision of outreach.
However, while we generally support the grant structure, grant
amounts, and grant-making process in H.R. 3008, two areas of this bill
should be amended to more closely match the variations in the veterans
benefits and services delivery system that exist across the 50 states,
the territories, and the District of Columbia (hereinafter referred to
as ``the states'').
First, while we concur that there is need in many rural parts of
the Nation to provide outreach to veterans in rural areas, we recognize
that many of the Nation's 24 million veterans live in areas that are
not rural. We recently noted with interest the VA's telephone call
outreach campaign to 570,000 of the 1.7 million veterans of the wars in
Iraq and Afghanistan who have not yet utilized VA services--presumably
a mix of rural, suburban, and urban. Veterans of the early years in the
war in Iraq may not be aware of new testing and treatment for brain
injury following blast exposure, post traumatic stress disorder,
treatment for the self-medicating but self-defeating effects of
substance abuse that may have only recently emerged, and so on. There
is much to be done with regards to providing desperately needed
outreach and services to our Nation's veterans, not just in rural areas
of the Nation, and H.R. 3008 brings us part way to reaching that goal.
Additionally, in the years following each war, Congress has
successively expanded healthcare and other benefits programs to meet
the needs of these warriors, including presumptive service-connection
and healthcare enrollment and specialized treatment for various
categories of veterans, including those with exposure to Agent Orange,
ionizing radiation, Project 112 including Project SHAD, Gulf War
illness, and for veterans who are ex-prisoners of war, purple heart
recipients, veterans with service after 1998, and more. More needs to
be done to reach out to these veterans as well, who are also presumably
a mix of rural, suburban, and urban.
As it is currently drafted, H.R. 3008 targets the grants
exclusively to outreach workers who are employees of counties. Less
than half the states, including Wisconsin, have benefits and outreach
workers who are county employees, most typically called county veterans
service officers (CVSOs). The language of the bill as it is currently
written could certainly benefit these states. However, the majority of
the states employ a variety of other models to provide services and
outreach to their state veterans.
In many of the states, there are service officers who are state
agency employees, typically called state service officers, including
Tennessee, New Mexico, and Illinois, whose Director of Veterans
Affairs, Tammy Duckworth, testified before this Subcommittee a few
weeks ago about her state's service state-employee service officers and
the need for the creation of an outreach grant.
A number of states contract with veterans service organizations
(VSOs) to provide veterans services, like Utah, or with other types of
non-profits, like Massachusetts.
In some states, including in New York, municipalities and other
non-county local governments provide direct veterans services and
outreach.
Many states, including Oregon, have a combination of several of
these outreach mechanisms.
The one thing all the states have in common is a state agency led
by a director charged to serve all veterans within the geographic
borders of the state. In order to effectively achieve the outreach
goals outlined in this bill, it must be amended with language broad
enough to cover veterans residing in all areas of the country in ways
that are locally effective.
The ability of State DVAs to provide Federal outreach funds to
reach veterans in the respective states, either through a grant or
through a contract, should continue to be allowed as under the original
bill. Therefore, use of the term ``non-profits'' should be retained.
To date, NASDVA has supported S. 1314, the Veterans Outreach
Improvement Act and the language it contains. For the reasons noted
above, NASDVA and the National Association of County Veterans Service
Officers (NACVSO) agreed to recommend that the following language be
included in S. 1314, which we believe more appropriately captures the
totality of the Nation's infrastructure available for the provision of
outreach to veterans nationwide:
A veterans agency of a State receiving a grant under this
subsection may use the grant amount for purposes described in
paragraph (1) or award all or any portion of such grant amount
to local governments in such State, other public entities in
such State, or private non-profit organizations in such State
for such purposes.
Of note, the term ``non-profit'' includes VSOs, which are
incorporated under one of the non-profit provisions of 501c of the
Internal Revenue Code.
H.R. 3008 is an important step in the right direction, and we
appreciate the recognition of the need for more outreach and services
by the bill's author, co-sponsors, and the leadership and Members of
this Subcommittee in allowing today's hearing on this bill.
H.R. 3795--You Were There, You Get Care Act
We support the expansion of presumptive service-connected
disability benefits to veterans who served in the Gulf War theater of
operations and other military operations involving depleted uranium. We
also support the independent medical study to identify other conditions
in addition to those already covered under existing laws covering
radiation.
H.R. 4274--Gold Star Parents Annuity Act of 2007
We support the creation of a stipend to surviving parents who are
the recipient of the Gold Star lapel button.
H.R. 5155--Combat Veterans Debt Elimination Act
We support the prohibition of collections on indebtedness for
military servicemembers who die of a service-connected disability
incurred or aggravated on active duty in a war or combat zone.
H.R. 5448--Full Faith in Veterans Act
We support the implementation of new criteria for the service-
connection of PTSD that reduces the burden of proof on the veteran and
requires the consideration for the inclusion of treatment records that
updates the provisions of the disability rating schedule regarding
PTSD, traumatic brain injury, and other mental disorders.
H.R. 5454--Presumption of service-connection for ALS
Given the growing recognition of an inexplicable association of
higher rates of amyotrophic lateral sclerosis among those with military
service than those without similar service, we support the presumption
of service-connection for ALS for wartime veterans.
H.R. 5954--Presumption of service-connection for Project 112 veterans
We support the presumption of service-connection for diseases
associated with biological, chemical, or other toxic agents for
veterans who were participants in Project 112, including Project SHAD,
regardless of whether their participation was knowing or unknowing,
willing or unwilling.
H.R. 5985--Compensation for Combat Veterans Act
We support the acceptance of records showing the veteran was
entitled to combat zone compensation as proof of combat service of
veterans for the purposes of certain veterans benefits. Given the
nature of current military operations, it is highly possible that small
groups of military servicemembers may be in combat operations and
entitled to combat zone compensation exclusion, which may be the only
publicly available evidence of their combat zone participation.
H.R. 6032--Wartime disability compensation for certain veterans with
Parkinson's disease
Given the growing recognition of an inexplicable association of
higher rates of Parkinson's disease among those with military service
than those without similar service, we support the presumption of
service-connection for Parkinson's disease for wartime veterans.
Statement of Denise Nichols,
Vice Chairman, National Vietnam and Gulf War Veterans Coalition
National Vietnam and Gulf War Veterans Coalition
Washington, DC.
June 12, 2008
To:
HVAC Subcommittee Disability Assistance
CC:
House Veterans Affairs Majority Staff
Subject:
Support for H.R. 3795--DU; H.R. 5954--BIOLOGICAL-CHEMICAL;
H.R. 5454--ALS; H.R. 6032--PARKINSON
Dear Representative Hall,
Today your Subcommittee is marking up excellent legislation that we
would like to wholeheartedly support. All the bills being brought up
should be supported fully. The bills we are most interested in H.R.
3795, 5454, 6032, 5954 are long overdue! Each of these bills address
urgent needs. The Gulf War veterans have a particular interest in H.R.
3795 and we are putting this on our hottest priority list! WE are
already pushing more Representatives to sign on and show their support
as cosponsors! We want these bills passed into law as fast as possible.
Bills H.R. 5454 and 6032 address two devastating diseases and the
veterans that are diagnosed with these need direct and immediate
attention. The numbers of both within the VA system are not
overwhelming and of course much lower than PTSD and the current combat
injured (amputations, etc) but they probably need more support long
term and that is the least we can do. We need to lift the burden of
continued claims battles these veterans face and these bills will
certainly serve to get them through that battle more rapidly so that
they can not be burdened by additional fights when they need to focus
on healthcare and battling to maintain their health as their central
issue. We complement the VA House Committee for bringing them the first
step in long term relief to the veterans that suffer these devastating
illnesses.
Bill H.R. 5954 the relief for Project Shad Veterans is long
overdue. Again the number of these veterans is small as compared to all
other groups and they have been forgotten for too long. We fully
support this bill moving forward rapidly.
We also support
H.R. 1197--POW
H.R. 5985--COMBAT VETERAN
H.R. 5448--PTSD
H.R. 5709--QUALITY CONTROL ON CLAIMS
H.R. 5155---DEBT RELEASE
H.R. 3008--RURAL CARE
Thank you for your efforts to make a real difference for all
veterans!
Sincerely,
Denise Nichols
Vice Chairman
Statement of John E. Olsen, ET-2, USN,
Billings, MT
Chairman Hall, Ranking Member Lamborn and distinguished Members of
the Committee. My name is John E. Olsen and I live in Billings,
Montana. I am a former ETN-2 (64-65) and I write to describe my
experiences within the ``Project SHAD Technical Staff'' (PSTS).
I entered the U.S. Navy in 1961 after 3 years at Montana State
University, including Advanced Army ROTC. After boot camp, I was
assigned to ET `A' school for preparation as an Electronic Technician
and assignment to the fleet. In 1964 I received orders to Project SHAD
Technical Staff on board the USS Granville S. Hall for LT 2085. In
normal transfers an enlisted person goes to the receiving station on
the coast involved. In my case that should have been ``RECSTA Treasure
Island'' in San Francisco bay. Instead, my orders were to the
``Presidio'' in San Francisco. A suite in a fancy barracks, and I did
not see anyone else in the building while I was there. A few days here,
then transported to Treasure Island and immediately bussed to the
airbase to catch a MATS flight to Pearl Harbor. The morning after
arrival I was picked up by car and driven to a warehouse and told to go
to an office in the back and up one flight. There I was met by a Chief
Petty Officer and a LT(jg), who I later learned was the Personnel
Officer for PSTS. Our conversation hinged on the concept of war;
whether the old style of breaking things and killing people or would we
rather just take over an ill populace. I was told that ``President
Kennedy had personally believed this and he had chosen us to carry this
concept into working order. We were the best at our primary jobs, could
handle very well other jobs on board a ship, and we could pass the
security clearance factor.'' Well, when our president wanted me for
special work, who was I to say no! Of course I accepted the challenge.
When the 2085 was tied up and the civilian crew had left, those of us
already in Pearl went to the boat and met our skipper and chief
engineer. Our skipper was a full Lieutenant and the Chief Engineer was
a senior E-6 Engineman about twice my age. All this for a small boat,
107 feet in length and mostly black in color. (Army colors) It needs
grey, but first we find out that we do not wear our Navy uniforms. Then
we gather on the Granville S. Hall for a security briefing that
informed us that we would not leave the base without an undercover
escort, one of which we may, or may not, figure out but there would be
someone else also covering us. We went out on shakedown cruises,
training on seamanship, and for our job in research. Then we had
firefighting training. We were brought as a crew into a `classroom'
setting and trained on the exposure suits and gas masks. This part of
the training was filmed by an Army photo unit. Then to the G.S. Hall
for shots, something special as we were only told the basics when we
got them. Then decontamination of the interior of the vessel using
challengers filled with betaPropilactone and formalin. I turned them on
and left the area, closing the hatch behind me. After the challengers
were empty they shut down and we opened the 85 and went back to our
home. No one told us it was safe to re-enter the boat. We still had
liquid running down the bulkheads in most of the vessel. We had sealed
only the refrigerator and opened the rest of the interior to assure
there were no bugs still on board. Now on to Emergency Ship handling
school where an E-4 (me), an E-6 (one of our cooks), and three officers
off a submarine, a Lieutenant Commander and two LTs (jg)'s made up the
class taught by a Commander.
We had five LTs and six crews, we were trained for our job, but
there was a President who had not been elected, but had assumed the
position after the death of our beloved JFK. Volunteers were requested
to keep one crew in Pearl and transfer the balance back to the fleet. I
elected to stay with the unit as I had earned advancement to E-5.
During the down time we put in electronic spares on each boat, cared
for the vessels, and a few excursions. One was the time a Russian
Trawler had need of spare parts only available in the port of Honolulu.
Well, on that day, while a Geodesic Survey ship and other `proper'
ships of the line were in the harbor, we were out with one of the LT's
equipped to spray agent, practicing our man overboard procedures. Grey
harbor tug manned by people in civilian clothes with the ability to lay
down a spray--and they had the long lenses and lots of film. Were we
out there as bait of a sort, I so believe to this day?
Election up coming, let's get up to strength by bringing in the
other new crews. Now we are back on our proper vessels getting ready
again to go into research, to work. Most of the engineering crew had
some experience with tugs but most of the ET's came from destroyers or
large vessels. But our Weathermen came off a carrier or a shore
installation, never anything as bouncy as a tug. The placard said
``This vessel not to be operated on ocean or coastwise waters, signed,
commandant U.S. Coast Guard'' and seemed to have validity. I do know
that one time I had a roll of 65 degrees and a pitch of 40 degrees as
this was what was needed to throw the gyro out of kilter, and it did.
OK, after the inauguration of LBJ we were ready to start Shady Grove.
This was to take place near Johnston Island and we needed to transit to
that site. We left Pearl Harbor on the 21st of January.
After arrival in Johnston Island we again deConned the interior of
the vessels before doing anything else. Our air group arrived, Marine
A4's and the ground crews. The General paid a visit to each boat. Soon
we were underway to run the initial test, and first series of trials to
get us acquainted with the actual procedures. About a week out at sea
then back into port for a couple days, then out to station again. The
weatherman and I strapped the theodalite in and proceeded to do the
wind balloons and information to control each evening, in code. Five or
6 days at sea then a couple days in, then back out. The testing takes
much of the night, then during the day a minimum crew operates the ship
to the lab ship then back to station. Minimum crew was one person on
the bridge and one person in the engine room, and I had been appointed
to day watch. Of course, that meant that during the tests I was asleep
in the sleeping quarters, never knowing what was leaking through the
filters, and going into my lungs. Our filters got everything down to 1
micron, but they were made of paper, and this was close to the ocean
and there was actual seawater in the area. Salt water and paper made
for paper changing its porosity, in other words, it leaked.
My morning at sea began before sunrise as I assisted the navigator
in shooting the stars to determine our position after the external
decon of the vessel. As the ship was opened up for day operations most
of the crew went to sleep and one engineer and myself brought the
vessel to the lab ship to off load the samples and get the special
supplies for the next nights tests. And so it went until April when we
completed ``Shady Grove'' and I was on my way back to Montana State
University. My field of study was Electrical Engineering and Business.
By the end of my first quarter on campus I needed to get some work
to keep me busy so I applied to the Electronic Research Laboratory. I
started with the Digital Data Systems group where we would be working
with Water Resources Research group. We developed the Snow Pack
measuring devices that are put into the mountain areas of the west. And
I built the prototype. After about 3 years of school, I finally earned
a BS degree in Commerce (General Business).
Now to work, and a large construction company looks like the place
to put my varied experience to work. After completing the field
training I am offered a position in the purchasing department of
Southwest Operations of Chicago Bridge and Iron Company. Since I had
more law courses in school I was given the pleasant chore of
contracting our company attorney, and one of the choices available was
Leon Jaworski and Associates. Good thing he had a number of attorneys
on staff as he was called to Washington, D.C., to head the Watergate
investigation. As we expand operations I am handed the steel buying and
before long become probably the largest single consumer of steel on the
Gulf Coast of the United States. About 1975 I was given the added
responsibility of managing the annual audit of SW operations, and this
is the year we go from `Over the Counter' to the New York Stock
Exchange. About this time that I am handed one of the largest jobs I
have ever had. Negotiating with and meeting the proposed supplier off
and on for a few months then one morning I receive a call, then place a
call to New York lasting about 10 minutes and I've spent over $10
million. I also furnished most of the steel for the last greenfield
refinery built in the U.S.
Next was Chemtrol Corporation as the Purchasing Manager of this
specialty insulation company. Fireproof and radiation proof insulation
was important in the nuclear power field anywhere in the world. And we
did it! I'm with the company only about a month when Three Mile Island
happened, and this certainly put a crimp in our future. After less than
a year I move to Sales Manager for an Electronics and Metrology
Company. We handle everything from single meters to plant process
control (Dow Freeport). We do temperature measuring of the GM first
battery powered vehicles to clocks on the space shuttle. It is during
this time that the first indication of possible troubles from SHAD
arise. I'm 41 and have hypertension, but then I have a massive spasm of
the heart muscle. The difference between a spasm and attack is a spasm
leaves no damage to the heart muscle, even though it can kill just as
dead. Very unusual as normal medications work only for a short time
then fail as the pressure goes up higher than before. Soon I am again
not getting paid so move back to Montana. The prognosis is not good.
I finally cannot afford medical care so end up with the VA hospital
in Miles City, still trying to nail this down. Finally a sophisticated
test shows a probable tumor within the body so I am sent to the Salt
Lake VA Hospital where the tumor is confirmed. I am scheduled for
surgery, but first I needed to be switched from the normal anti-
Hypertensive to a quick acting variety when a timing fluke reared its
ugly head. My blood pressure went up to over 300+/300+. The nurse told
me I wasn't supposed to be there any longer, but I made it to the
operating room and had an adrenal tumor removed. I did not feel, per
what I had been told upon leaving SHAD, that I could tell the medical
people that my internal fluids might be hazardous to their health. But
I did survive this and went on to live without blood pressure problems
for quite some time, but now have had a mild attack which took me to a
cardiologist some 2 weeks after the event for one stent. Skin cancer,
prostate cancer, replaced hip, arthritis, COPD, and now osteoporosis
and scoliosis of the lower spine for me and only some cancer in the
family history make me wonder, was it SHAD.
From the age of 41 I have been unable to find work of a nature to
fit my field of study, or that would pay anywhere near the amount I had
earned at the electronic sales job that I had then. If that salary were
brought to the present it would be in the neighborhood of $150,000, and
with that I could have some funds set aside for retirement, but the
best I have done since then has been below $18,000. That's not enough
to leave a nest egg.
Statement of Paralyzed Veterans of America
Mr. Chairman and Members of the Subcommittee, on behalf of
Paralyzed Veterans of America (PVA), we would like to thank you for the
opportunity to submit a statement for the record regarding the proposed
legislation. We appreciate the fact that you continue to address the
broadest range of issues with the intention of improving benefits for
veterans. We particularly support any focus placed on meeting the
complex needs of the newest generation of veterans, even as we continue
to improve services for those who have served in the past.
H.R. 1197, THE ``PRISONER OF WAR BENEFITS ACT OF 2007''
This legislation would repeal the requirement that a Prisoner of
War (POW) be held captive for at least 30 days in order to receive a
presumption of service-connection for the purposes of receiving
benefits. This issue was first considered during the 108th Congress
after American service personnel who were held captive in Iraq during
the early stages of the war were released or rescued after less than 30
days of internment. These men and women had sustained severe injuries
as a result of combat actions and their subsequent internment. It seems
only fair that any POW, regardless of time in captivity, be recognized
as being eligible for service-connected benefits. PVA supports this
provision.
We likewise support the addition of the following diseases to the
list of diseases presumed to be service-connected; Type II diabetes and
osteoporosis. We have no objections to the requirements placed on the
Secretary of VA for adding or subtracting diseases to the presumptive
service-connection list. We would only caution that veterans and former
POWs should be given the benefit of the doubt before any consideration
is given to removing a disease from the list.
The legislation also allows a survivor of a veteran to continue to
receive dependency and indemnity compensation for the death of a
veteran resulting from such disease on the basis of such presumption
after a disease is removed from regulations. PVA supports this
provision of the legislation.
H.R. 3008, THE ``RURAL VETERANS SERVICE OUTREACH AND TRAINING ACT''
The ``Rural Veterans Service Outreach and Training Act'' is
intended to improve outreach activities performed by the VA. It does so
by creating a grant program for states to help fund their rural county
veteran service officers. A state is eligible to apply for a grant if
it has at least one county where veterans reside, and that county does
not have a service officer. State eligibility may also include a county
that has a service officer working part time, or a county that has more
that 1000 veterans residing in it and has a full-time county veterans
service officer but can still demonstrate a need for additional
services by a county service officer.
The maximum grant amount available is $1,000,000 and states will be
able to apply annually. States are required to provide a 20 percent
match to receive the funds and states must use the funds to increase
their outreach activities and not to supplement existing programs.
We believe this program can demonstrate to new veterans, as well as
veterans from past conflicts that state governments along with the
federal government are making a real effort to ensure that they receive
the information, services, and benefits that they have earned. PVA
generally supports the provisions in this proposed legislation.
H.R. 3795, ``YOU WERE THERE, YOU GET CARE ACT OF 2007''
PVA supports H.R. 3795, the ``You Were There, You Get Care Act of
2007.'' This legislation allows for the men and women who served in the
1991 Persian Gulf War and conflicts since that date to be considered to
be radiation-exposed for the purpose of service-connection as a result
of exposure to depleted uranium. However, we believe that this
legislation should be expanded to include veterans who served prior to
the first Gulf War. During the eighties, U.S. Army armor units located
in Germany and South Korea carried armor piercing shells that were made
from depleted uranium. While servicemembers understood that there were
hazards associated with depleted uranium, they still spent weeks at a
time in the tanks with these shells radiating uranium. As such, these
veterans should also be included in this category for presumptive
service connection.
H.R. 4274, THE ``GOLD STAR PARENTS ANNUITY ACT OF 2007''
PVA has some serious concerns about this proposed bill. First, we
question how this benefit would be applied in a situation where a
veteran has a surviving spouse or dependents as well as surviving
parents. We do not believe that this is an appropriate benefit if the
veteran has a surviving spouse or dependents because those individuals
already would be the designated beneficiaries for all survivor
benefits. Payments under this bill would be nothing more than a
secondary survivor benefit to the parents.
While PVA always supports benefits that recognize the sacrifices
made by our servicemembers, we believe that providing $125 per month as
a recognition for the death of a service man or woman is a slap in the
face at best. The value of this benefit suggests that the life of the
man or woman who served and died honorably is worth almost nothing.
Moreover, to create a situation where separated parents might receive a
$62 per month reminder of their son's or daughter's service and death
is beyond comprehension. While intentions for this legislation might be
good, this bill will certainly create more heartache and pain rather
than honorable recognition. With these thoughts in mind, this
legislation should be reconsidered.
H.R. 5155, THE ``COMBAT VETERANS DEBT ELIMINATION ACT OF 2008''
PVA principally supports H.R. 5155, the ``Combat Veterans Debt
Elimination Act of 2008.'' However, we have a couple of concerns with
the proposal. First, we believe that the legislation should afford the
same benefit to any servicemember who might have been killed while
serving in the line of duty. We do not think that a special distinction
should be made between a servicemember who was killed in a combat
theater and a servicemember who was killed while serving at his or her
home duty station. We would ask; ``What is the difference between
having a tank roll over on the individual in Iraq or Afghanistan, or a
tank roll over on the individual at Fort Hood, Texas?'' The benefit of
this legislation should be afforded to any servicemember killed while
serving this nation honorably.
Second, we wonder why a special exception is made in this
legislation for certain debts to be collected. As we understand the
bill, the only debt that the VA will be permitted to collect upon a
servicemember's death is a home loan or small business loan.
H.R. 5448, THE ``FULL FAITH IN VETERANS ACT OF 2008''
PVA supports H.R. 5448, the ``Full Faith in Veterans Act of 2008.''
This legislation will help address the high number of post traumatic
stress disorder (PTSD) cases from Operation Iraq Freedom/Operation
Enduring Freedom (OIF/OEF) as well as veterans from previous conflicts.
As more information becomes available from the VA's Mental Health
Centers of Excellence and other professional sources pertaining to the
diagnosis and treatment of PTSD, this information must be available to
all VA health care providers.
The latest information must also be available to the VA's Vet
Centers. Vet Centers are often the only VA representation in rural
areas, and most Vet Centers are the first point of contact for veterans
in rural areas with PTSD, as well as other mental health conditions.
H.R. 5454, ALS
PVA supports H.R. 5454, a bill that provides a presumption of
service connection for Amyotrophic Lateral Sclerosis (ALS) for any
veterans that served during a period of war.
Studies published in medical neurology journals indicate a higher
level of ALS among servicemembers that served in the Gulf War than any
other segment of the general population. Although, at this time there
is no causal effect standard for determining presumption, more research
should be funded by the VA for current veterans with ALS and future
cases. We support this presumption of service connection for these
veterans since there is currently no medical evidence to refute the
increased incidence among veterans.
H.R. 5709, THE ``VETERANS DISABILITY FAIRNESS ACT''
PVA supports the provisions of H.R. 5709, the ``Veterans Disability
Fairness Act.'' We hope that this legislation will correct the
inconsistencies of ratings that veterans receive from different VA
regional offices. We have heard testimony over the last couple of years
about veterans that may receive a 70 percent rating in one location,
and be rated 100 percent in another region. While we understand that no
veterans' claims are the same, there is still a great deal of
inconsistency in application of adjudication standards and regulations.
This legislation requires the VA to conduct reviews and audits
annually to identify and correct inaccuracies or inconsistencies in
disability ratings and the adjudication of claims for disability
compensation. The VA can use that information to address the
differences that occur nationally. To minimize the variability among
regional offices, the VA must increase training, improve rater
qualifications, and increase the quality review system.
In the Veterans' Disability Benefits Commission report, released in
October 2007, the Institute of Medicine (IOM) recommended that
educational and training programs for VBA raters and VHA examiners be
developed, mandated, and uniformly implemented across all regional
offices with standardized performance objectives and outcomes. These
programs should make use of advances in adult education techniques.
External consultants should serve as advisors to assist in the
development and evaluation of the educational and training programs. We
believe this legislation begins to address this recommendation, but it
could do more.
We look forward to working with the VA and Congress to improve the
consistency in disability ratings for veterans throughout the system.
H.R. 5954, PRESUMPTION OF SERVICE CONNECTION FOR PROJECT 112
PVA supports H.R. 5954, a bill to provide veterans with a
presumption of service connection for purpose of benefits for diseases
associated with service in the Armed Forces and exposure to biological,
chemical, or other toxic agents as part of Project 112.
The Department of Defense (DoD), originally denied the occurrence
of tests including chemical and biological agents until a government
investigation identified these tests. Project Shipboard Hazard and
Defense (Project SHAD) was conducted between 1962 and 1974. Of the
20,000 veterans that may have been exposed to these chemicals, VX nerve
gas, Sarin Nerve Gas and E.Coli, all known to be harmful chemicals,
only 6,000 veterans have been identified. This bill will ensure that
all veterans that may have incurred a disease as a result of exposure
to these chemicals will receive the medical care they deserve.
Section 2 of the bill requires the DoD to release all records that
will allow the VA to identify the other 14,000 veterans involved in
Project 112. It is time that the DoD finally sets the record straight
and comes clean about all of the activities surrounding Project 112/
SHAD.
H.R. 5985, THE ``COMPENSATION FOR COMBAT VETERANS ACT''
PVA fully supports H.R. 5985, the ``Compensation for Combat
Veterans Act.'' This proposed legislation is in accordance with a
recommendation included in The Independent Budget for FY 2009. As
stated in The Independent Budget:
While VA recognizes the receipt of certain medals as proof of
combat, only a fraction of those who participate in combat
receive a qualifying medal [qualifying medals include combat
badges and medals received for valor]. Further, military
personnel records do not document combat experiences except for
those who receive certain medals. As a result, veterans who are
injured during combat or suffer a disease resulting from a
combat environment are forced to try to provide evidence that
does not exist or wait a year or more while the Department of
Defense conducts research to determine whether a veteran's unit
engaged in combat.
This legislation will clarify the status of veterans that have
served in a combat zone and have suffered a disease or injury. This
will eliminate the need to establish evidence for proof of service-
connection. H.R. 5985, when signed into law, will save the veteran
valuable time in developing their claim to submit to the VA when they
seek the medical care for an injury or disease as a result of their
combat service.
It is important to note that this legislation would not eliminate
or alter in any way the requirement that a veteran's claim for
disability have an official diagnosis or that a clear connection
between that claimed disability and military service exists. It would
simply relieve the burden placed on veterans who served in a combat
theater of proving that the claimed disability was combat-related. As
it currently exists in law, service in a combat zone or theater does
not necessarily meet the threshold that the VA has established for
recognizing a combat veteran. This loophole needs to be changed to
benefit the veteran and we believe this legislation will accomplish
that task.
H.R. 6032, PRESUMPTION OF SERVICE CONNECTION FOR
PARKINSON'S DISEASE
PVA supports H.R. 6032, a bill that provides a presumption of
service connection for Parkinson's disease for certain veterans who
served in the Republic of Vietnam. The 109th Congress passed
legislation that required the Secretary to designate six centers of
excellence for Parkinson's disease research, education, and clinical
activities. These facilities will have an arrangement with an
accredited medical school that provides training in neurology and
diagnosis and treatment of neurodegenerative diseases. Medical evidence
has indicated a higher rate of Parkinson's disease among veterans that
have served in Vietnam. With the passage of this legislation, a veteran
that develops Parkinson's disease will be able to receive the latest
treatment for this devastating condition.
Mr. Chairman, we would like to thank you again for the opportunity
to submit a statement for the record. We look forward to working with
the Subcommittee to ensure that the best benefits are available to all
veterans.
Statement of Alan Oates,
Edinburg, VA, Member, U.S. Military Veterans with Parkinson's (USMVP)
Dear Chairman and Committee Members,
I am Alan Oates, a Vietnam Veteran. I have Parkinson's disease. I
am a member of an organization called ``U.S. Military Veterans with
Parkinson's'' (USMVP). Our organization and members haven't received
any Federal Grant Funds nor do we have any contracts with the U.S.
government.
Parkinson's is a degenerative, progressive disease without a cure.
The physical, mental and financial burden on Vietnam Veterans suffering
with this disease and their families is devastating.
Public Law 102-4 was passed to provide a better means to address
Agent Orange and the health issues that Vietnam Veterans faced.
Congress recognized the need for an agency outside of the VA to look at
these issues. Especially since the VA's own report by Admiral Zumwalt
stated that the VA's review Committee on Agent Orange was so biased to
Veterans that they should be fired. The VA classified this report to
keep it from the public.
However due to flaws and failed implementation of Public Law 102-4,
the system created by Congress to help these Vietnam veterans has
failed them. It has failed the Veteran who recently emailed me,
pleading for help as his Parkinson's had left him unable to work and
almost homeless--. and the Veteran who at 58 years of age was left so
helplessly immobile in bed that his wife has to cauterize him twice a
day. Let there be no doubt that their Parkinson's is a result of their
service to their Country in Vietnam.
I have met with the staff of many of the Members on this Committee
and have provided extensive documentation and justification for passing
this bill. As in written testimony I am limited to ten pages total, I
am only including selected exhibits.
After extensive research we have found:
Vietnam Veterans were exposed to a large number of toxic
chemicals including Agent Orange and Organophosphates.
Evidence that connects Parkinson's disease to service in
Vietnam and to exposure to various chemicals used in military
operations.
The Department of Veterans Affairs and the system
established under Public Law 102-4 to look at the disease in Vietnam
Veterans has failed these Veterans.
I. Vietnam Veterans were exposed to a multitude of chemicals
during their military service in Vietnam. Agent Orange and
Malathion (Malaoxon) are two of those.
A. Agent Orange consisted of two herbicides, 2,4-D and
2,4,5-T. The production of 2,4,5-T created the toxic
dioxin, TCDD. This is considered one of the most toxic
dioxins known to man.
1. The Institute of Medicine in the Agent
Orange Review reports that the TCDD in Agent
Orange could be up to 1,000 times more toxic
than that in the same herbicide used outside of
military operations (farming and home use).
This is important as most studies using the
2,4,5-T herbicide are based on a less toxic
form than that used in Agent Orange.
II. Malathion is an organophosphate insecticide.
Organophosphates were developed by Nazi Germany in the late
1930's as a Chemical Warfare Nerve Agent. These agents impact
the Central and Peripheral Nervous System.
A. Operation Flyswatter exposed Vietnam Veterans to
Malathion routinely every 9 days weather permitting.
B. The long storage times, high heat and exposure to
sunlight cause Malathion to break down into a highly
toxic Malaoxon.
III. Agent Orange and Malathion individually and in
combination are scientifically associated to Parkinson's
disease.
IV. Evidence of Association between Parkinson's disease and
military service in Vietnam.
A. Stanford University Military Deployment Study
Abstract (Exhibit A) found an increase of 2.6 times in
the risk for Parkinson's disease in veterans who
deployed to Vietnam compared to those who did not.
B. Dr. Chris Reid provides a nexus between service in
Vietnam and Parkinson's.
V. Agent Orange Association
A. In the Iowa Agriculture Health Study Update 2007
(Exhibit B), Dr. Kamel found that 2,4,5-T (Agent Orange
herbicide) was associated with an increased risk in
Parkinson's disease.
B. In the BMC Neurology Study published March 28,
2008, a strong Odds Ratio was found between 2,4-D and
Parkinson's disease even though the association had not
reached a scientific significant level.
C. A study showing how 2,4-D can impact the portion of
the brain related to dopamine productions.
``Intracerebral administration of 2,4-
diclorophenoxyacetic acid induces behavioral and
neurochemical alterations in the rat brain. Bortolozzi
A.''
D. A study showing alterations in dopamine in basal
ganglia by 2,4-D in neonatal exposed rats, mediated by
a serotonergic modulation on the dopaminergic system.
E. A study shows that 2,4-D can damage the
cytoskeleton structure of brain cells and disrupts the
microtubule of neuron cells. (2,4-D Acid Disrupts the
Cytoskeleton and Disorganizes thee Golgi apparatus of
Cultured Neurons) Silvan B. Rosso April 5, 2000).
Another study shows that when the microtubule is
disrupted in a dopamine carrying cell, it causes
dopamine to leak from the cell and kill the dopamine
cells. (Jian Feng Microtubule: A Common Target for
Parkin and Parkinson's Disease Toxins). The loss of
dopamine cells causes Parkinson's disease.
F. A study (2,3,7,8-Tetracholorodibenzo-p-dioxin
exposure disrupts granule neuron precursor maturation
in the developing mouse cerebellum. Collins LL.)
Demonstrates the ability of alter neuron cells.
VI. Organophosphates Malathion Evidence of Association
A. The BMC Neurology Study published 28 March 2008
finds scientifically significant association between
Organophosphates (Malathion) and Parkinson's disease.
B. There are numerous studies showing how
organophosphates are suspect in the development of
Parkinson's disease.
VII. Public Law 102-4 has failed the Vietnam Veterans.
A. The law failed to address the issue that were many
chemicals exposure and not just Agent Orange for
Vietnam Veterans and narrowly focused on only the
herbicides used in military operations.
B. The Institute of Medicine (IOM) in conducting its
research for the Agent Orange Reviews is limited to
researching only the Diseases as they are associated
with herbicides used in Vietnam.
C. The IOM charge is to look for a scientific
connection between a disease and the herbicides and not
to look for a connection between a disease and Veterans
service in Vietnam.
D. An example of this is in the IOM AO 2006 review as
cited by the Department of Veterans Affairs in the
Federal Register on presumptiveness for Peripheral
Neuropathy. A study found some association with service
in Vietnam but not to the chemicals of interest. The
focus should be, is there evidence of an association
between the disease and the Veterans service in
Vietnam.
E. IOM will not look at other chemicals such as
Organophosphates as their charge by law is limited to
herbicides. There are many cases where other chemical
exposures such as Organophosphates and solvent
contribute to or cause a disease.
VIII. The Department of Veterans Affairs (DVA) has failed to
implement requirements of the law.
A. Public Law 102-4 required the DVA to conduct
studies that were recommended by the IOM in the Agent
Orange Reviews.
1. DVA failed to conduct studies recommended
by the IOM in the Agent Orange Reviews.
a. Since 1994 in each review IOM has
stated the importance of seeing if
there is an early onset of Parkinson's
disease in exposed veterans.
b. The importance of studies comparing
exposed to non exposed veterans.
B. DVA failed to collect and review the clinical data
on illnesses and disease related to Agent Orange in
Vietnam Veterans.
1. This is evident by the fact that the DVA
has been unable to provide even the number of
Vietnam War Zone Veterans they are treating for
Parkinson's disease. A request was made on my
behalf by Congressman Goodlatte on April 9 for
information on Vietnam Veterans with
Parkinson's, as of this date.
C. DVA has not provided this information. DVA failed
to recognize that a finding of a biologic plausible
mechanism in the IOM Agent Orange review is a causal
relationship.
1. Public law 102-4 required the NAS (IOM) to
look to see if there is evidence of a biologic
plausible mechanism ``or other'' causal
association.
a. By using the words ``or other''
Congress and the law is clear that a
finding of evidence of a biologic
plausible mechanism is a causal
association.
2. The VA Appeal Board has found service
connection for Parkinson's disease due to
herbicide exposure in two cases that we have
found. In one of those cases the VA admits a
finding of Biologic Plausibility and the appeal
court judge rules in favor of the Veteran based
partly on that point.
IX. DVA is required by law to evaluate the evidence for and
against presumptiveness of a disease and rule in favor of
presumptiveness if the evidence for is equal to or greater than
the evidence against an association. DVA must also publish its
findings on presumptiveness in the Federal Register and give
the scientific basis for that finding.
A. In the 2006 Agent Orange Review, IOM stated, ``In
pursuing the question of statistical association, the
Committee recognized that an absolute conclusion about
the absence of association is unattainable. As in
science generally, studies of health effects associated
with herbicide exposure cannot demonstrate that a
purported effect is impossible or could never occur.
Any instrument of observation, even the most excellent
epidemiologic study, is limited in its resolving power.
In a strict technical sense, therefore, the Committee
could not prove the absence of an association between a
health outcome and exposure to any of the compounds of
interest. That contributed to the current Committee's
decision to re-evaluate findings on the health
endpoints classified in Update 2004 as having
``suggestive evidence of no association.''
This is a dramatic change from the prior position
of the IOM. ``Studies of health effects associated with
herbicide exposure cannot demonstrate that a purported
effect is impossible or could never occur.'' Since a
negative association is not technically possible the
credible evidence provided by the IOM at the worst can
only be viewed as neutral by DVA when evaluating a
disease for presumptiveness.
X. Since a positive causal association exists, not only
because of the biologic plausibility but because of other
credible evidence, DVA should have already approved
presumptiveness for Parkinson's disease.
The system and the DVA have failed Vietnam Veterans. We bring our
issues to the Veterans' Affairs Committee and the House of
Representatives (The People's House) to correct and right this
injustice. We ask that the Committee do two things:
First, pass H.R. 6032 and give these Veterans, who on the
average have already suffered with this service connected disease for 6
years and individually up to 25 years, the help they so desperately
need. They can not afford to wait any longer for the system to be fixed
and to then address this issue.
Second, make the necessary changes to the system to
insure that they will correct the problems and issues we have addressed
in this document.
Thank you for the opportunity to provide input on this important
issue.
Excerpted Figures from
``Improving the Presumptive Disability
Decision-Making Process for Veterans''
Committee on Evaluation of the Presumptive Disability
Decision-Making Process for Veterans
Board on Military and Veterans Health
Jonathan M. Samet and Catherine C. Bodurow, Editors
Institute of Medicine of the National Academies
FIGURE S-1--ROLES OF THE PARTICIPANTS INVOLVED
IN THE PRESUMPTIVE DISABILITY
DECISION-MAKING PROCESS FOR VETERANS
[GRAPHIC] [TIFF OMITTED] T3058A.001
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a Stakeholders include (but are not limited to) veterans service
organizations (VSOs), veterans, advisory groups, Federal agencies, and
the general public; these stakeholders provide input into the
presumptive process by communicating with Congress, VA, and independent
organizations (e.g., the National Academies).
b Congress has created many presumptions itself; in 1921, Congress
also empowered the VA Secretary to create regulatory presumptions; on
several occasions in the past, Congress has directed VA to contract
with an independent organization (e.g., the National Academies) to
conduct studies and then use the organization's report in its
deliberations of granting or not granting regulatory presumptions.
c VA can establish regulatory presumptions; VA sometimes contracts
with the National Academies to conduct studies and uses the
organization's report in its deliberations of granting or not granting
regulatory presumptions.
d The National Academies (Institute of Medicine and National
Research Council) submit reports to VA based on requests and study
charges from VA.
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FIGURE S-2--PROPOSED FRAMEWORK FOR FUTURE PRESUMPTIVE
DISABILITY DECISION-MAKING PROCESS FOR VETERANS
[GRAPHIC] [TIFF OMITTED] T3058A.006
---------------------------------------------------------------------------
a Includes research for classified or secret activities, exposures,
etc.
b Includes veterans, veterans service organizations (VSOs), Federal
agencies, scientists, general public, etc.
c This committee screens stakeholders' proposals and research in
support of evaluating evidence for presumptions and makes
recommendations to the VA Secretary when full evidence review or
additional research is appropriate.
d The board conducts a two-step evidence review process (see report
text for further detail).
e Final presumptive disability compensation decisions are made by
the Secretary, Department of Veterans Affairs, unless legislated by
Congress.
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CONGRESSIONAL RESEARCH SERVICE
MEMORANDUM
October 21, 2008
To:
House Committee on Veterans' Affairs,
Subcommittee on Disability Assistance and
Memorial Affairs
Attention: Kimberly Ross
From:
Sidath Viranga Panangala, Analyst in Veterans
Policy, 7-0623
Subject:
Follow-up to Question Posed at the Legislative
Hearing on June 12, 2008
This memorandum responds to a question posed by Chairman John Hall
at the legislative hearing on June 12, 2008. During that hearing
Chairman Hall asked the following question:
Does ALS [Amyotrophic Lateral Sclerosis] manifest more than a year
after separation or does the veteran sometimes take that long or longer
to recognize the symptoms and come to the [Department of Veterans
Affairs] VA?
Studies done regarding military service and ALS are quite limited,
and published literature does not provide a clear answer about the
post-service timeframe over which such an association may be seen. This
memorandum provides a brief summary of the Institute of Medicine (IOM)
review done to examine an association between ALS and military service
and discusses current VA policy establishing a presumption of service-
connection for ALS.
Introduction
Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's
disease, is a rapidly progressive medical condition that affects a
person's nervous system.\1\ The Institute of Medicine (IOM) of the
National Academy of Sciences reports that ALS causes nerve cells in the
brain and spinal cord to degenerate. This degeneration in turn causes a
breakdown in communication between the nervous system and the voluntary
muscles of the body, and eventually leads to muscle paralysis.
Moreover, muscles responsible for breathing are affected, and
respiration fails.\2\ It affects about 20,000-30,000 people--of all
races and ethnic backgrounds--in the United States at any given
time.\3\ Most people who are diagnosed with the disease die from
respiratory failure within 3 to 5 years of the onset of symptoms.\4\
About 10 percent of patients with ALS survive for 10 or more years.\5\
It has been reported that the rate of progression of the disease varies
from patient to patient.\6\
---------------------------------------------------------------------------
\1\ National Institute of Neurological Disorders and Stroke,
National Institutes of Health, ``Amyotrophic Lateral Sclerosis Fact
Sheet,'' September 9, 2008, [http://www.ninds.nih.gov/disorders/
amyotrophiclateralsclerosis/detail_amyotrophiclateralsclerosis.htm].
\2\ National Academy of Sciences, Institute of Medicine (IOM),
Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific
Literature (2006) p. 7.
\3\ Ibid.
\4\ Ibid.
\5\ National Institute of Neurological Disorders and Stroke,
National Institutes of Health, ``Amyotrophic Lateral Sclerosis Fact
Sheet,'' September 9, 2008, [http://www.ninds.nih.gov/disorders/
amyotrophiclateralsclerosis/detail_amyotrophiclateralsclerosis.htm].
\6\ National Academy of Sciences, Institute of Medicine (IOM), Gulf
War and Health: Health Effects of Serving in the Gulf War vol 4.
(2006), p. 153.
---------------------------------------------------------------------------
Military Service and ALS
Many returning veterans from the Persian Gulf War began reporting
numerous health problems that they believed to be associated with their
service in this war.\7\ Among the conditions reported were symptoms
associated with ALS. Given this concern among veterans that there is an
increased risk of developing ALS among those who served in the Persian
Gulf War, the VA asked the IOM to conduct an independent assessment of
the potential relationship between military service and the later
development of ALS. The IOM Committee did not address, nor was it asked
to consider, the timeframe over which ALS symptoms appeared in veterans
who succumbed to the disease. Based on a review of the scientific
literature, the IOM Committee concluded that ``there is limited and
suggestive evidence of an association between military service and
later development of ALS.'' \8\
---------------------------------------------------------------------------
\7\ Ibid. p. 1.
\8\ National Academy of Sciences, Institute of Medicine (IOM),
Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific
Literature (2006), p.36. According to IOM, ``limited and suggestive
evidence'' would indicate that evidence is suggestive of an association
between military service and ALS in humans, but the body of evidence is
limited by the inability to rule out chance and bias, including
confounding factors, with confidence.
---------------------------------------------------------------------------
Compensation for Disabilities Associated with ALS and Military Service
In 2001, the then VA Secretary made a policy decision to give
special consideration to ALS disability claims by Persian Gulf War
Veterans who served during the period August 2, 1990-July 31, 1991.
Under this policy veterans with ALS who served during other periods
would not receive disability compensation.\9\
---------------------------------------------------------------------------
\9\ Department of Veterans Affairs, ``Presumption of Service
Connection for Amyotrophic Lateral Sclerosis,'' 73 Federal Register
54691, September 23, 2008.
---------------------------------------------------------------------------
The VA subsequently announced in September 2008 that it would
establish a presumption of service-connection for ALS for any veteran
who develops the disease at any time after separation from service.\10\
This would relieve the veteran of the burden to prove that ALS was
caused by a specific exposure or activity that occurred during service
in the Armed Forces. To be eligible for this presumptive service-
connection, a veteran must have served on continuous active duty for a
period of 90 days or more. The VA made this decision based on the
understanding that further research is unlikely to clarify this
association between ALS and military service, and there is sufficient
evidence indicating a correlation between ALS and activities in
military service that supports establishment of a presumption of
service-connection for ALS for any veteran with that diagnosis.\11\ VA
also noted that it could revisit this presumption if scientific and
medical advances in the future show that ALS is not associated with
activities during military service.\12\
---------------------------------------------------------------------------
\10\ Ibid.
\11\ Ibid.
\12\ Ibid.
H.R. 5954, 2nd Session of 110th Congress
Presumptions of Service Connection for Purposes of Benefits under
Laws Administered by Secretary of Veterans Affairs for Diseases
associated with Service in the Armed Forces and Exposure to Biological,
Chemical, or other Toxic Agents as part of Project 112
Issue
H.R. 5954, Presumption of Service Connection for Diseases
associated with Exposure to Biological, Chemical, or other Toxic Agents
as part of Project 112.
Purpose
H.R. 5954, proposes to amend subchapter 1, chapter 11, of title 38,
United States Code, with the addition of a new section 1119 entitled
``Presumptions of service connection for diseases associated with
Project 112'' that will:
Establish a presumption of service connection for any
disease determined by the Secretary to have resulted from an increased
incidence of exposure to a biological, chemical, or other toxic agent
during service or having been directly or indirectly subjected to a
chemical or biological warfare test under Project 112.
Require the Secretary to determine the presumptive period
that such disease must have manifest to warrant entitlement of service
connection.
Establish presumption of such exposure if the veteran
participated in a Project 112 test and defines what constitutes Project
112 test.
Instruct the Secretary to notify all veterans that were
potentially exposed as the result of Project 112 not later than 180
days after enactment of the legislation. The Department of Defense will
be tasked to transfer the records of active duty personnel and
reservists that were potentially exposed within 30 days after
enactment.
Task VA to submit a report to Congress within 1 year
after enactment concerning Project 112. The report will accomplish the
following: (1) Document the costs, benefits, and challenges associated
with continuing the search for additional Project 112 participants; (2)
provide a full accounting of all information known concerning Project
112 participants; and (3) address other concerns regarding Project 112
held by the VA, veterans, or veterans service organizations.
Program Views on Proposed Legislation
Highlights
This proposed legislation defines presumption of exposure for a
Project 112 partcipant, directs the Secretary to determine what
diseases are associated with such exposure and also to determine any
presumptive time frame, instructs VA to contact potentially exposed
veterans, and requires that VA deliver a report to Congress concerning
the effects of Project 112.
Program Views
Project SHAD, an acronym for Shipboard Hazard and Defense, was part
of a larger effort called Project 112 which was a comprehensive program
initiated in 1962 by the Department of Defense (DoD) to protect and
defend against potential chemical and biological warfare threats.
Project SHAD encompassed a series of tests by DoD to determine the
vulnerability of U.S. warships to attacks with chemical and biological
warfare agents, and the potential risk to American forces posed by
these agents. Project 112 tests involved similar tests conducted on
land rather than aboard ships. Project SHAD involved servicemembers
from the Navy and Army and may have involved a small number of
personnel from the Marine Corps and Air Force. Servicemembers were not
test subjects, but rather were involved in conducting the tests.
Animals were used in some, but not most, tests.
DoD continues to release declassified reports about sea--and land--
based tests of chemical and biological materials concerning Project
112. VA is working with DoD to obtain information as to the nature and
availability of the tests, who participated, duration and agents used.
DOD estimates that about 6,000 veterans may have been involved in
Project 112/SHAD. To date, DOD has provided VA with the names of
approximately 5,000 veterans who participated in the tests. VA began,
in May 2002, to contact veterans who participated in Project SHAD about
medical care and benefits to which they may be entitled.
In October 2002, VA contracted with the Institute of Medicine (IOM)
to conduct a three-year, $3 million study of potential long-term health
effects of tests conducted on board Navy ships in the sixties. IOM's
report, Long-Term Health Effects of Participation in Project SHAD, was
published in May 2007 and found no clear evidence that specific long-
term health effects are associated with participation in Project SHAD.
VA opposes this legislation. We have already contracted for a
significant long-term study concerning the health effects of SHAD
participants and received the report from the IOM. The Secretary has
authority to contract for an additional study if it is deemed
necessary. We do not believe that enactment of this legislation is
warranted at this time due to the lack of credible scientific and
medical evidence that adequately demonstrates any statistically
significant correlation between participation in SHAD tests and the
subsequent development of any disease.
Costs (Mandatory and Discretionary)
Mandatory Benefit Costs
This bill provides disability compensation to veterans with
diseases associated with toxic agents and disability indemnity
compensation to survivors of such veterans. The Department of Defense
estimates that 6,442 veterans are currently alive who were exposed to
toxic agents through Project 112. Under this proposal, the Secretary
would determine which diseases warrant a presumption of service
connection for this population and publish decisions in regulations.
The Institute of Medicine (IOM) of the National Academies released
their report, ``Long Term Health Effects of Participation in Project
SHAD'' on May 30, 2007. IOM could not clearly connect any conditions to
toxic exposure in SHAD. VA therefore assumes that no conditions would
be determined presumptive for service-connection based on involvement
in Project 112. We are unable to provide a cost estimate for this bill
without further support.
Discretionary GOE Costs
There would be no discretionary costs as this proposed legislation
would have no significant impact on workload.
Contacts
For questions please contact Adrienne Foster, at 202-461-9690, C&P
Service Budget Staff (211C) or Christina DiTucci, ORM Benefits Budget
Division (244A), at 202-461-9928.
Committee on Veterans' Affairs
Subcommittee on Disability Assistance and Memorial Affairs
Washington, DC.
June 23, 2008
Hon. Michael L. Dominguez
Principle Deputy Under Secretary of Defense
for Personnel and Readiness
U.S. Department of Defense
1300 Pentagon Defense
Washington, DC 20301
Dear Mr. Dominguez:
In reference to our House Committee on Veterans' Affairs
Subcommittee on Disability Assistance and Memorial Affairs Legislative
Hearing on H.R. 1197, H.R. 3008, H.R. 3795, H.R. 4274, H.R. 5155, H.R.
5448, H.R. 5454, H.R. 5709, H.R. 5954, H.R. 5985 and H.R. 6032 on June
12, 2008, I would appreciate it if you could answer the enclosed
hearing questions as soon as possible.
In an effort to reduce printing costs, the Committee on Veterans'
Affairs, in cooperation with the Joint Committee on Printing, is
implementing some formatting changes for material for all Full
Committee and subcommittee hearings. Therefore, it would be appreciated
if you could provide your answers consecutively on letter size paper,
single-spaced. In addition, please restate the question in its entirety
before the answer.
Due to the delay in receiving mail, please provide your response to
Ms. Megan Williams by fax at (202) 225-2034. If you have any questions,
please call (202) 225-3608.
Sincerely,
John J. Hall
Chairman
______
Questions for the Record
The Honorable John J. Hall, Chairman,
Subcommittee on Disability Assistance and Memorial Affairs,
House Veterans' Affairs Committee
June 12, 2008
Legislative Hearing on H.R. 1197, H.R. 3008, H.R. 3795, H.R. 4274,
H.R. 5155, H.R. 5448, H.R. 5454, H.R. 5709, H.R. 5954,
H.R. 5985, and H.R. 6032
H.R. 3795
Question 1: Please inform the Committee whether Depleted Uranium
(DU) is widely used by the military, for example, in anti-tank weapons,
tank armor and ammunition rounds.
Answer: The United States military uses DU in armor penetrating
munitions fired by Abrams tanks, Bradley Fighting Vehicles, and several
aircraft systems, including the A-10. Depleted uranium also provides
defensive armor for Abrams tanks. Depleted uranium is generally limited
to combat situations involving enemy tanks, and, therefore, is not
currently in wide use in theater. It also has some uses in the civilian
community, including in stabilizers in aircraft and boats.
H.R. 3795
Question 2: Does the DoD agree that Persian Gulf War veterans were
exposed to greater amounts of DU than the average citizen?
Answer: Most Persian Gulf War veterans had no greater exposure to
depleted uranium (DU) than does the average U.S. citizen. The
Department of Defense (DoD) and the Department of Veterans Affairs
maintain DU medical management programs to assess Servicemembers and
veterans for possible DU exposure. The Department classifies personnel
into three possible levels of exposure, and requires DU testing for
those personnel in the two groups at the highest risk of exposure.
Personnel at lower risk of exposure may also undergo testing based on
concerns of the medical care provider or the patient. Thus far, DoD has
tested almost 2,500 personnel serving in Operation Iraqi Freedom for DU
in their urine specimens. Of these, only 10 have been positive for DU,
most of whom had elevated levels associated with the presence of
embedded DU fragments. However, the remainder of the 2,500 personnel
tested have not shown elevation of urine uranium above the expected
background level of natural uranium.
H.R. 3795
Question 3: According to an article published by the U.S. National
Library of Medicine and the National Institutes of Health, American
soldiers involved in ``friendly fire'' accidents during the 1991 Gulf
War were injured with depleted-uranium-containing fragments or possibly
exposed to depleted uranium via other routes such as inhalation,
ingestion, and/or wound contamination. Through urine samples, it was
found that most of these soldiers had above-average DU concentrations
in their bodies. Those studies only pertain to ``friendly fire''
injuries, so these figures would likely be much higher if all veterans
were taken into consideration. Given these facts, does the DoD think
that there is a slight possibility that even some Gulf War Veterans
were exposed to DU and hence may be at greater risk of developing
cancer?
Answer: The Department generally concurs with the conclusions of
the National Academy of Medicine (NAM) in its analysis of depleted
uranium (DU) exposures during the 1991 Gulf War, which to a great
extent have been based on decades of data arising out of industrial
exposures to natural uranium. It is important to note that neither
occupational exposure to natural uranium nor military exposure to DU
(which is 40 percent less radioactive than natural uranium) has been
shown to cause cancer in humans. Much of what is known about the
exposure to and absorption of DU is derived from the scientific
literature on natural uranium, which the NAM discusses at great length.
All humans are exposed daily to natural uranium through inhalation
and ingestion, and excrete it in their urine. Servicemembers on the
battlefield are also exposed to natural uranium. In some unusual
situations, they may be exposed to DU. After studying the
Servicemembers with the highest risk of exposure to DU, it has become
clear that the presence of embedded DU fragments is the main factor
that results in long-term DU exposure. Neither ``friendly fire''
victims without embedded fragments, nor other individuals with lesser
exposures, have had increased uranium in their urine that would
indicate levels of exposure to DU that would have an adverse health
effect.
Those Servicemembers and veterans at greatest risk for possible
exposure to DU are required to undergo medical evaluation by DoD or the
Department of Veterans Affairs. Urine biomonitoring is the most
sensitive technique for determination of excessive intake of DU,
including inhalation and ingestion, and exposures in excess of
occupational safety and health guidelines are readily detectable
through elevation of urine uranium. About 80 veterans involved in
``friendly fire'' incidents have been extensively evaluated, some since
1993. Despite elevations of urine uranium levels in those personnel
with remaining embedded DU fragments, no medical conditions associated
with uranium exposure have been detected in any of the examined
veterans during comprehensive medical evaluations.
Some individuals not involved in ``friendly fire'' incidents and
without embedded DU fragments are undergoing urine screening for DU
because of military occupations that require them to work on damaged
tanks, or possibly subject them to other low-level exposures. The
Department has not identified any individual in this group who has
tested positive for DU in the urine, and significant DU exposures are
unlikely to have occurred in the absence of DU in the urine. Based on
the absence of associated disease occurring in individuals involved in
``friendly fire'' incidents, and the negative biomonitoring results
from others possibly at risk of exposure, DoD believes that those at
risk of developing uranium-associated disease are limited to the small
group invited to participate in long-term medical follow-up
H.R. 3795
Question 4: Additionally, the World Health Organization lists lung
tissue damage leading to a risk of lung cancer as a potential effect of
inhalation of large amounts of radioactive DU, and a DU Follow-up
Program conducted by the Baltimore Division of the VA Maryland
Healthcare System in January of 2000 found that health effects are
related not only to the presence of uranium, but also to the amount of
time or duration a person is exposed. It seems that any health effects
are due to the total amount of exposure, not just the effects of a
single incidence. Did the DOD take into account the duration of the
exposure and the potential effects the length of time might have on
servicemembers?
The Committee has been apprised of a study conducted by a Northern
Arizona University biochemist in 2006 that reveals that uranium can
bind to and has profound and debilitating effects on human DNA. The
findings seem to establish that when cells are exposed to uranium, the
uranium binds to DNA and the cells acquire mutations, triggering a
whole slew of protein replication errors, some of which can lead to
various cancers. Please provide a response to these findings and
indicate whether the DoD concludes that this research may shed light on
the possible connection between exposure to depleted uranium and Gulf
War Syndrome?
Answer: The Department follows with interest the results of all
relevant literature and research on the effects of uranium or depleted
uranium (DU) on humans and mammalian systems. These must be interpreted
based on whether they use in vivo (live animal) or in vitro (cell
culture) models and what the studies are designed to measure. Medical
science has evaluated health effects of natural uranium for more than
50 years and DU for more than 20 years. Because DU is a heavy metal
with minimal radioactivity, it would exert a toxic effect mainly as a
chemical hazard rather than radioactive hazard. A few industrial
workers (not 1991 Gulf War veterans) have developed kidney disease
after taking in large amounts of uranium, due to its chemical
properties. However, no human cancer, including lung cancer, has been
linked to exposure to either natural uranium or DU.
According to the World Health Organization, because ``DU is only
weakly radioactive, very large amounts of dust (on the order of grams)
would have to be inhaled for the additional risk of lung cancer to be
detectable in an exposed group.'' The Institute of Medicine concluded
that there was suggestive evidence of no association between exposure
to uranium and lung cancer at doses 2-10 times higher than the maximum
dose estimated in the DU Capstone Study. The Army's DU Capstone Study
assessed DU dust levels in scenarios in which DU munitions struck
vehicles, and calculated the incremental cancer risks of occupants in
those vehicles under a variety of conditions, some of which were
extreme. One of these conditions was the length of time occupants
remained in the vehicle. The analysis supported the view there would be
little or no long-term impact on the health of personnel from
inhalation of DU particulates inside tanks or other vehicles struck by
DU munitions.
The Department is aware of publications by Diane Stearns and
Virginia Coryell, of Northern Arizona University, in 2005 and 2006,
which examined survival of Chinese hamster ovary cells exposed to a
form of DU. While the results of the study suggest possible
genotoxicity from the chemical effects of uranium exposure in a
mammalian tissue culture system, these results must be viewed in
perspective. Uranium is an element that is found everywhere in our
environment, although some parts of the Earth contain higher
concentrations of it in the soil. On average, more than four tons of
natural uranium exists in the top foot of soil in every square mile on
Earth. All humans are exposed to low levels of uranium on a daily
basis, including in food, water, and the air we breathe. Everyone has
about 80 milligrams of naturally occurring uranium in their body as a
result of natural exposure, and excretes uranium in the urine. Most
substances that we encounter have adverse effects in certain situations
or concentrations, and studies of undesirable effects from excess
exposures must be interpreted by comparison to usual exposures, or the
norm. However, there is no way to compare the Northern Arizona
University results with what would constitute a normal exposure.
Furthermore, Service members evaluated for DU exposure are measured
against a norm of low levels of natural uranium, rather than the total
absence of uranium. Personnel with confirmed elevations in uranium
levels are referred to the DU program for long-term medical follow-up.
Significant elevations in urine uranium levels are associated with the
presence of embedded DU fragments, and represent continuing exposures.
Even after more than 15 years of follow-up for some individuals with
embedded fragments of DU, no health effects resulting from their DU
exposures have been detected other than wounds caused by the DU
fragments. In addition, no birth defects have been observed in any of
the offspring of these veterans. From Operation Iraqi Freedom
deployments, about 2,500 personnel at elevated risk of DU exposure have
undergone testing, and only 10 have been confirmed positive and
referred for continued follow-up.
H.R. 5454
Question 5: Please inform the Committee when the results of these
research projects you mention in your Statement for the record (DAMA
Subcommittee hearing, June 12, 2008) will be available.
Answer: Two of the ongoing research projects will finish in 2009:
Harvard University--``Prospective study of Amyotrophic
Lateral Sclerosis Mortality Among World War II, Korea, and Vietnam
veterans;'' and
University of Cincinnati--``Biomarkers for Amyotrophic
Lateral Sclerosis in Active Duty Military''
Other projects should complete in 2010.
H.R. 5454
Question 6: You admit that there are a few reports that show a
possible association between ALS and military service, but you maintain
that this is still insufficient evidence. So what would you consider to
be sufficient evidence that would lead the DoD to conclude that there
is some level of causation between military service and ALS?
Answer: The Department concurs with the conclusion of the Institute
of Medicine (IOM). The IOM published a report on Amyotrophic Lateral
Sclerosis (ALS) in November 2006, entitled ``Amyotrophic Lateral
Sclerosis in Veterans: Review of the Literature.'' Based on the
strength of the scientific evidence, the IOM concluded that there was
``limited and suggestive evidence of an association between military
service and later development of ALS.'' This means the IOM concluded
the evidence was not strong enough for causation. A causal relationship
requires stronger scientific evidence than an association requires.
The IOM stated that about 5-10 percent of ALS cases in the general
population are inherited, and the causes of the remaining 90-95 percent
of cases are not known. Similarly, in the studies of ALS in veterans,
about 10 percent of the cases were inherited, and the causes of 90
percent of the cases were not known. IOM pointed out that there have
been many ALS studies in the general population that examined
occupations, physical trauma, strenuous physical activity, and
lifestyle factors, but there have been no consistent results.
The IOM made a recommendation to ``conduct further corroborative or
exploratory studies to elucidate ALS risk factors relevant to military
service.'' There are several ongoing research studies that are
evaluating the possible relationship between military service and later
development of ALS. When completed, these studies will provide
additional evidence on whether military veterans are at increased risk
for developing ALS, compared with individuals who did not serve in the
military.
H.R. 5454
Question 7: On June 12, 2008, there was testimony delivered during
the DAMA Subcommittee hearing by a veteran diagnosed with ALS (Jeff
Faull) who cited a study funded by the DoD that found that veterans of
the 1991 Gulf War are approximately twice as likely to develop ALS as
those not deployed to the Gulf. Would the DoD consider this as
sufficient evidence to conclude causation between ALS and military
service?
Mr. Faull also referred to a study conducted at Harvard that
concluded that veterans from other eras, ranging from before World War
II to after Vietnam, are also twice as likely to develop ALS as those
who have never served in the military, regardless of whether the
service was during time of peace or war, or at home or abroad?
Moreover, the study indicated that veterans were at greater risk of
becoming afflicted with ALS regardless of whether they served during a
time of war or peace, or whether they served at home or abroad. Is the
DoD aware of this study? If not, please inform the Committee of the
DoD's opinion on the results of the aforementioned study now that it is
aware.
Answer: The Department is aware of the study, ``Occurrence of
Amyotrophic Lateral Sclerosis, Among Gulf War Veterans,'' published in
the medical journal, Neurology, in September 2003. The Institute of
Medicine (IOM) published a report on ALS in November 2006, entitled
``Amyotrophic Lateral Sclerosis in Veterans: Review of the
Literature.'' On pages four and five of this report, the IOM states,
``the results of a single study are not sufficient evidence to conclude
causation between Amyotrophic Lateral Sclerosis (ALS) and military
service.'' The Department of Defense (DoD) concurs with IOM's
conclusion that the results of a single study are insufficient.
The Department is aware of the study conducted by Harvard
University researchers, ``Prospective Study of Military Service and
Mortality from Amyotrophic Lateral Sclerosis,'' published in Neurology
in January 2005. The Department reviewed this study and determined that
it used appropriate methods. In fact, DoD provided funding to the
Harvard University researchers to perform additional research on ALS in
veterans of World War II, Korea, and Vietnam.
H.R. 5954
Question 8: Has the DoD provided the Department of Veterans Affairs
with all of the names of participants in the Project SHAD and Project
112 testing?
Answer: The Department of Defense (DoD) has provided the Department
of Veterans Affairs (VA) with all the names of the participants in
Project 112 and Project Ship Hazard and Defense (SHAD) that it has
discovered to date. The Department vigorously pursues any new leads it
receives on possible exposures in Project 112/SHAD. If during our
investigations of these leads, we find new Project 112/SHAD exposures,
DoD immediately notifies the VA.
H.R. 5954
Question 9: Please provide a response to the U.S. Government
Accountability Office's claims that the DOD needs to provide a more
objective analysis of the costs and benefits of actively searching for
Project 112 participants and that until then your efforts are
questionable? The Committee adds that the GAO also stated that the
American public cannot be assured that the DoD's current effort is
reasonable and effective until you address the following limitations:
a. DOD's effort lacks clear and consistent objectives, scope of
work, and information needs that would set the parameters for its
effort.
b. DOD has not provided adequate oversight to guide this effort.
c. DOD has not fully leveraged information obtained from previous
research efforts that identified exposed individuals.
d. DOD's effort lacks transparency since it has not kept Congress
and veterans service organizations fully informed of the progress and
results of its effort.
Answer: In late 1991 and continuing for approximately 5 years, the
Department of the Army, as the Department of Defense (DoD) executive
agent, responded to several congressional inquiries on behalf of three
possible Project Shipboard Hazard and Defense (SHAD) veterans. In 1992,
the Army confirmed the existence of Project SHAD and provided, in
relation to these specific inquiries, vessels involved, test locations,
and substances used. In 1994, the Army provided unclassified or
redacted documents. In 1998, renewed interest in the release of
additional information on the Project 112 test program developed. In
August 2000, the Department of Veterans Affairs (VA) asked DoD to
provide more information on SHAD tests. At that time, VA wanted
information on three tests--Autumn Gold, Copper Head, and Shady Grove--
to satisfy pending claims.
In September 2000, DoD assigned responsibility for the
investigation to the organization now known as Force Health Protection
and Readiness (FHP&R). FHP&R personnel held weekly meetings with VA to
ensure that DoD's search produced information that would be useful
information to VA. This information included dates/location of tests,
vessels involved, lists of agents, stimulants, tracer material, and
decontaminants used. VA did not request agent concentration
information. VA decided that if an illness was linked to an exposure,
the veteran would receive compensation.
DoD's investigation indicated that the Desert Test Center (DTC)
planned both shipboard and land based testing. Investigators quickly
determined that there were a significant number of tests conducted. In
all, DTC personnel planned for 134 tests and conducted 50. DoD decided
that veterans of individual tests should not have to wait for a full
report of the investigation. Investigators prepared fact sheets for
each test and delivered the names of exposed individuals to VA as soon
as they compiled and declassified the necessary information. DoD
provided information on Autumn Gold, Copper Head, and Shady Grove to VA
on September 13, 2001, and simultaneously posted fact sheets relating
to these tests on the FHP&R web site. DoD continued this procedure
(develop fact sheets on tests, identify veterans possibly exposed, post
the fact sheets on the FHP&R Web site, and notify VA of the individuals
exposed on those tests) until the investigation was completed.
In researching Project 112/SHAD, DoD investigators compiled over
34,000 pages of relevant material. Locations searched for documents
included West DTC, Dugway Proving Grounds, Navy Historical Center,
Naval Surface Warfare Center, Edgewood Chemical and Biological Center,
United States Army Chemical Center and School, Defense Technical
Information Center, National Archives, Office of Naval Research, and
the Office of the Secretary of Defense Historical Office. The discovery
of DTC annual and semi-annual progress reports was a major breakthrough
in the investigation that allowed a better understanding of the
universe of tests planned. Many of these documents remain classified
for national security reasons. However, without compromising national
security, DoD investigators declassified portions of relevant documents
and used this declassified material to build fact sheets for each test
that accurately reflects the nature of Project 112 testing.
During its investigation, DoD found no test specific medical
records or classified medical records. Technical reports on tests did
not include personally identifiable information on the health effects
of exposures. The purpose of these tests was to assess dissemination
characteristics and operational countermeasures, not health effects on
personnel.
Identification of Navy personnel was straightforward. Test
documents identified the dates of the test and the trials associated
with each test. Using these dates and the Enlisted/Officer Distribution
and Verification Report (Quarterly listing of the ship's crew), ship's
deck logs, and the ship's personnel diary, investigators identified
personnel on-board during tests. Unfortunately, these documents are not
available for the Navy tugs involved in several tests and complete
information on these vessels is still lacking.
Identifying individuals on land-based tests proved more difficult.
DoD investigators identified military personnel who participated in
these tests from test officers' log books, temporary duty orders,
country clearance measures, overtime reports, letters of commendation,
and similar documents. DoD investigators were able to identify
personnel on only one-third of the land-based tests.
Investigators could not totally identify three other groups of
Project 112 personnel: the aircrews who loaded the spray tanks used on
some SHAD tests, the pilots who flew spray missions, and members of the
Project 112 technical staff.
In August 2003, we provided Congress with a complete report,
detailing our efforts to identify Project 112/SHAD testing and the
individuals possibly exposed during this testing. Since our 2003 report
to Congress, DoD received numerous phone calls and letters from
veterans relating to participation in Project 112. These veterans have
shared with us temporary duty orders, letters of commendation, etc.,
that enabled us to identify additional Service members involved in
Project 112. However, these individuals were not able to identify
locations that might contain additional SHAD documents.
Additionally, the Institute of Medicine (IOM) conducted a study of
the ``Long-Term Health Effects of Participation in Project SHAD,''
publishing its report in 2007. In support of this effort, DoD provided
IOM with the Project 112 Exposure database. Using the same documents
used by DoD, IOM reviewed the database and identified additional
personnel possibly exposed. Working with IOM, DoD validated an
additional 394 SHAD participants.
The Department is currently identifying all non-Project 112/SHAD
personnel possibly exposed to chemical and biological agents from World
War II to the present. The DoD contractor conducting research for this
effort completed a review of documents available at Dugway Proving
Ground. During this review, they found no new individuals associated
with Project 112 tests. They did find some additional tests for a few
civilians already identified as participating in known Project 112
tests.
Having conducted an exhaustive search for information on Project
112/SHAD, DoD does not concur that any degree of searching records
archives for a long ago terminated program would result in a more
complete documentation of all aspects of the program. The evidence
found produces an accurate picture of Project 112/SHAD. We currently
know of no other investigative leads that would meaningfully supplement
that picture. We instructed the current contractor looking for non-
Project 112/SHAD exposures to collect the names of any individuals they
discovered exposed in Project 112. FHP&R will investigate any new
information that may be presented and share that information with VA
and the public.
The DoD program and actions address the intent of the GAO
recommendations. The GAO stated that DoD had ``agreed to and has in
some cases begun taking action to respond to the five
recommendations.'' The Department updated its program goals and
objectives to identify individuals who were possibly exposed during
chemical and biological tests outside of Project 112. The revised
statement of work, implementation plan, and concept of operations
ensure consistent guidance and deliverables that are responsive to the
GAO recommendations.
The Office of the Special Assistant for Chemical and Biological
Defense and Chemical Demilitarization Programs oversees the current
program and has established an implementation plan with the Deputy
Assistant Secretary of Defense (Force Health Protection and Readiness)
(DASD(FHP&R)) delineating program oversight responsibilities. The
following controls are in place: monthly reporting, quarterly program
reviews, and data reviews with key personnel from the office of the
DASD(FHP&R). As recommended by GAO, the DoD program manager conducts
quarterly site visits.
Under the revised statement of work, the support contractor
conducts research to identify other organizations performing similar
work. During quarterly reviews, the contractor presents analyses and
reports on those sources that it recommends should be coordinated with
and leveraged to identify additional individuals possibly exposed. As
noted in DoD written comments to the draft GAO report, DoD continues to
identify Project 112 participants when new leads or information is
shared with us or VA from any source, including former Service members
and others knowledgeable of these tests. DoD continues to develop and
provide guidance to individuals possibly exposed during these tests.
The DASD(FHP&R) continually adds information to its website to
update the public on DoD's current efforts. FHP&R is upgrading this Web
site to include information on possible exposures outside of Project
112/SHAD. In February 2008, representatives of the DASD(FHP&R) briefed
the veterans and military service organizations on our efforts and the
DASD(FHP&R) will continue to brief these organizations on a periodic
basis.
H.R. 5985
Question 10: If this bill is not enacted, how would the DoD suggest
making, maintaining, and transmitting military records amidst the often
chaotic environment in which they are created in combat?
a. What does/would the DoD do in a situation where a
servicemember's combat records are lost or otherwise irretrievable?
Answer: The proposed amendment does not improve the likelihood of a
fair hearing in these cases, because it proposes the addition of a
provision to establish Service connection that would require
information from official records. Lost records place an unfair burden
on a veteran who is seeking to establish Service connection for a
disease or injury. The Department provides assistance to reconstruct
lost records, but this is not a guarantee that the information needed
to prove Service connection will be recovered.
Current law already addresses cases where official records cannot
be used to provide Service connection. Title 38, United States Code,
section 1154, subsection (b) clearly establishes a different burden of
proof for the veteran and the government in cases where Service
connection is called into question. This is evidenced by two provisions
in the subsection:
First, the Secretary of Veterans Affairs shall accept
satisfactory lay or other evidence that the disease or injury was
incurred or aggravated by service, which involved the engagement of the
enemy in combat as sufficient proof of Service connection. If there is
no official record that the disease or injury was incurred or
aggravated by such service, the Secretary shall resolve every
reasonable doubt in favor of the veteran.
Second, the criterion for a rebuttal of a claim for
Service connection is the presentation of clear and convincing evidence
to the contrary.
The legal framework for a reasonable evaluation of the evidence and
a fair decision concerning a claim for Service connection is already
established. The addition of a criterion to consider service in a
combat zone to be equivalent to service, which involves engaging the
enemy in combat, really does not address the issue of lost records.
H.R. 5985
Question 11: Given the changing dynamic of combat in the current
OEF/OIF conflicts (where there are virtually no lines or enemies in a
certain uniform and where there are not many ``safe areas'') please
explain how the DoD identifies a combat area, i.e., an area where a
servicemember would engage in combat with the enemy?
Answer: There may be several definitions of ``an area where a
Service member would engage in combat with the enemy,'' depending
whether the context is operational or for other purposes. For the
purpose of establishing eligibility for tax benefits under section 112
of the Internal Revenue Code, the Department identifies a potential
``combat zone'' as an area, both land and sea, where combat operations
are either occurring or likely to occur. Once a consensus is reached on
the area, the Department drafts an Executive Order and recommends that
the President sign the order, formally establishing the Combat Zone.
H.R. 5985
Question 12: Service Medals are typically presented on a unit
basis. Please describe how the DoD defines ``engaged in combat with the
enemy'' for the purposes of awarding service medals. How does the DoD
award service medals to those service members who ``engaged in combat
with the enemy'' apart from his/her assigned unit, i.e. truck drivers
on a convoy, etc.?
Answer: The term ``Department of Defense Service medals''
encompasses all of the Department of Defense (DoD) Campaign,
Expeditionary, and Service medals, including the Afghanistan Campaign
Medal (ACM), Iraq Campaign Medal (ICM), Global War on Terrorism
Expeditionary Medal, Global War on Terrorism Service Medal, Kosovo
Campaign Medal, National Defense Service Medal, and many others. Many
of these medals include criteria that authorize award based on a
Service member being engaged in combat with the enemy. Specifically,
the ACM and ICM criteria authorize award for being ``engaged in combat
during an armed engagement,'' regardless of the amount of time spent in
the area of eligibility. It is the responsibility of unit commanders,
many of whom are on the ground in Iraq and Afghanistan, to determine if
a Service member's specific situation constitutes actual combat during
an armed engagement that would warrant award of the ACM or ICM. The
Department and the Services do not define ``engaged in combat during an
armed engagement'' for the purpose of awarding the ACM and ICM in order
to allow as broad an interpretation as possible.
The majority of Service members are awarded DoD Service medals, not
for being engaged in combat, but for serving the required number of
days in the specified area of eligibility. For those Service members
who are authorized the award based on combat engagements, it is the
Service member's responsibility to request award based on the ``engaged
in combat during an armed engagement'' criteria and to notify their
local chain-of-command of the qualifying combat engagement. The local
commander verifies eligibility based on witness statements from other
personnel present at the time of the combat engagement. The authority
to authorize award of DoD Service medals has been delegated down to the
local command level in order to expedite processing of such requests.
H.R. 5985
Question 13: On average, what is the waiting period for a deserving
servicemember to receive a medal for military service?
a. Please describe the process for awarding service medals.
b. Are there avenues to expedite this process?
Answer: The Department of Defense (DoD) Service medals include
Campaign, Expeditionary, and Service medals. Examples of DoD Service
medals include the Iraq Campaign Medal (ICM), Afghanistan Campaign
Medal (ACM), Global War on Terrorism Expeditionary Medal, Global War on
Terrorism Service Medal, and National Defense Service Medal, to name a
few. Each military department is responsible for prescribing
appropriate regulations for administrative processing and awarding of
DoD Service medals.
The Services do not track the waiting period for a Service member
to receive a DoD Service medal. As one would expect, processes for
award of Service medals vary for each Service based on its respective
regulations and award systems. However, since determining eligibility
is basically an administrative review to ensure eligibility criteria
have been met, the timeframe between providing proof of eligibility and
updating personnel records is minimal, normally less than 30 days.
Award authority is delegated to the local commander in order to
expedite the award process. The Department is aware of no avenue to
further expedite this process nor is there evidence to suggest that
there is a problem with the timely award of DoD Service medals.
H.R. 6032
Question 14: Please comment on the results of the most recent IOM
Report on the possible health effects of Agent Orange and other
herbicides used during the Vietnam War?
Answer: The Institute of Medicine (IOM) report ``Veterans and Agent
Orange Update 2006'' was released in late 2007. The update fulfills the
mandates of the Agent Orange Act 1991 and the Veterans Education and
Benefits Expansion Act for the National Academy of Sciences, which
require a comprehensive evaluation of scientific and medical
information on the health effects of exposure to Agent Orange, other
herbicides used in Vietnam, and the chemical components of those
herbicides.
The Department of Veterans Affairs (VA) established an internal VA
Work Group to formally review the report. The Department awaits the
completion of VA's formal review. This update will assist in the
development of VA policy related to disability determination for
Vietnam veterans claiming injury from Agent Orange exposure.