Thursday, August 16, 2012

VA Proposing PN change and no additions to AO List

Today the VA announced a proposed change to its policy on Peripheral Neuropathy and the decision not to add any new conditions or diseases based on the last IoM report [Veterans and Agent Orange Update 2010]. Here is the information on Peripheral Neuropathy:
"VA proposes to remove the current requirement that acute and subacute peripheral neuropathy appear “within weeks or months” after exposure and remove the requirement that the condition resolve within two years of the date of onset in order for the presumption to apply. For purposes of consistency, VA further proposes to replace the terms “acute and subacute” with “early-onset” in 38 CFR 3.307(a)(6)(ii) requiring peripheral neuropathy to become manifest to a degree of 10 percent or more within one year after the last date of herbicide exposure in order to be subject to presumptive service connection under 38 CFR 3.309(e). This amendment would clarify that presumptive service connection for early-onset peripheral neuropathy will not be denied solely because the peripheral neuropathy persisted for more than two years after the date of last herbicide exposure. However, this amendment would not change the current requirement that peripheral neuropathy must have become manifest to a degree of 10 percent or more within one year after the date of last exposure in order to qualify for the presumption of service connection. In Update 2010, the NAS found that evidence did not indicate an association between herbicide exposure and delayed-onset peripheral neuropathy, which NAS defined as peripheral neuropathy having its onset more than one year after exposure.
and....
Additionally, we propose to revise 38 CFR 3.816(b)(2), the regulation governing retroactive awards for certain diseases associated with herbicide exposure as required by court orders in the class action litigation in the case of Nehmer v. U.S. Department of Veterans Affairs. Currently § 3.816(b)(2) states that the Nehmer court orders apply to presumptions established before October 1, 2002, and lists the diseases covered by those presumptions, including “acute and subacute peripheral neuropathy.” Rather than revising this list, we propose to remove the list of conditions and the October 1, 2002, date and insert language clarifying that the Nehmer court orders apply to the presumptions listed in § 3.309(e). This change is necessary because the district court and the U.S. Court of Appeals for the Ninth Circuit in Nehmer found the date restriction and the corresponding listing of presumptive conditions based on herbicide exposure found at § 3.816(b)(2) to be invalid as it is not inclusive of all conditions the Secretary has determined to be presumptively service connected based on herbicide exposure under the Agent Orange Act of 1991. Therefore, VA proposes to remove paragraphs (b)(2)(i)-(ix) and the phrase “before October 1, 2002” and to add a reference to § 3.309(e) that reflects the inclusive listing in the introduction to paragraph (b)(2). The above information can be reviewed for comment at: https://www.federalregister.gov/articles/2012/08/10/2012-19635/determinations-concerning-illnesses-discussed-in-national-academy-of-sciences-report-veterans-and#p-34
No great change here. Additionally, the VA declined to add any new diseases or conditions to the list of Agent Orange Diseases. Here are the important sections.
Limited or Suggestive Evidence of an Association NAS has defined this category of association to mean that the “evidence suggests an association between exposure to herbicides and the outcome, but a firm conclusion is limited because chance, bias, and confounding could not be ruled out with confidence.” Hypertension VA has reviewed this additional information in relation to the information in prior NAS reports analyzing studies concerning hypertension. Based on this review, the Secretary has determined that the available evidence presented in Update 2010 is not sufficient to establish a new presumption of service connection for hypertension in veterans exposed to herbicides. As noted in VA's evaluation of prior NAS reports, 75 FR 32540 (Jun. 8, 2010), the evidence overall includes a wide variety of results. While some veteran studies have reported increased incidence of hypertension, others have found no increase. Similarly, numerous environmental and occupational studies have found no significant increased risk of hypertension. The consistently negative findings of occupational studies are of interest because, at least in studies of chemical-production workers, the magnitude and duration of exposures in occupational studies generally would be greater than in Vietnam veteran studies. Further, as noted above, several of the studies that provide evidence of an increased risk are limited by the failure to control for significant confounders or by other methodological concerns. Accordingly, the Secretary has determined that the available evidence does not at this time establish a positive association between herbicide exposure and hypertension that would warrant a presumption of service connection.
Now we take this to rule out Hypertension by itself. However, as a secondary to Diabetes Mellitus Type II, or Ischemic Heart Disease, it still would go into an approved claim’s mix for rating percentage of disability.
Inadequate or Insufficient Evidence To Determine an Association Based on the analysis in Update 2010, the Secretary has determined that the available studies generally do not provide credible evidence of an association between exposure to an herbicide agent and an increased risk of hearing loss, eye problems, or bone conditions. The Secretary therefore finds that a positive association does not currently exist between herbicide exposure and those conditions and that no presumption of service connection is warranted for those conditions at this time.
Limited or Suggestive Evidence of No Association NAS has previously concluded that there is limited or suggestive evidence of no association between paternal herbicide exposure and spontaneous abortion. In Update 2010, NAS identified no new studies relevant to that health outcome. Accordingly, the Secretary has determined that there is no positive association between paternal herbicide exposure and spontaneous abortion.
Detailed information on NAS' findings may be found at http://www.iom.edu/Reports/2011/Veterans-and-Agent-Orange-Update-2010.aspx. After selecting the link titled: “Read Report Online for Free,” report findings, organized by category, may be found under the heading, “Table of Contents.”
To read the entire posting and/or make a comment go to this website: https://www.federalregister.gov/articles/2012/08/10/2012-19634/disease-associated-with-exposure-to-certain-herbicide-agents-peripheral-neuropathy#h-16
Again, no real surprises here. Nothing much changes except for Peripheral Neuropathy.

VNVets

”It is a stain on this nation's honor that the Department of Veterans Affairs has become a deadlier and more difficult adversary to the American veteran than any they have ever faced on a battlefield."-- VNVets

"The concept that Agent Orange, and its effects, stopped dead in its tracks at the shoreline is simply too illogical, and too ludicrous to accept. What does that say about the Obama Administration and his Department of Veterans Affairs?"--VNVets

"With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation's wounds; to care for him who shall have borne the battle, and for his widow, and his orphan--to do all which may achieve and cherish a just and lasting peace, among ourselves, and with all nations." --President Abraham Lincoln

"It follows then as certain as that night succeeds the day, that without a decisive naval force we can do nothing definitive, and with it, everything honorable and glorious."--President George Washington

Copyright © 2005-2012: VNVets Blog -- Now in our Eighth Year of Service to Veterans; All Rights Reserved. Reprinting or copying of the contents of this blog without the express permission of the author is unlawful.

Monday, August 13, 2012

Update on Congressional and IOM Efforts



Okay, enough is enough.  So the Marines, who seem to always get what they want, get their Camp Lejeune contamination benefits.  And the Vietnamese get millions of dollars to cleanup around Danang. 

Yes, both are certainly and most assuredly well deserved.  So indeed are the pending benefits for the Blue Water Navy. 

Just to put something into perspective, there are some other things at play here regarding the Danang cleanup. 

A few years ago a very senior member of the Senate Veterans Affairs committee spoke to a few of us in a hallway after a joint House-Senate VA hearing.  His comments baffled us at the time.  He said, “Danang!  We ought to take that back!” 

The Chinese and the Philippines have laid claim to two small island groups off Vietnam, the Paracel Islands, and the Spratley Islands.  In fact, the Vietnamese Navy, built mostly of Russian ships, tangled with the People’s Republic of China Navy twice over those islands, back 25-35 years ago.  Each side won one confrontation. 

What’s the big deal about those Islands? 

Oil and Natural Gas.  Both island groups have rather large fields of gas and oil under them. 

Enter the Russians.  They, too, are seeking a future supply of gas and oil.  So they are seeking a naval and air base in Vietnam.  Likely they are after Cam Ranh Bay.   

So, when that Senator said “Danang!  We ought to take that back!”, we had no clue then what he was talking about, but it certainly becomes evident now why we are cleaning up Danang.  It is good will building in hopes of gaining access to the Naval and Air facilities there after they are cleaned up.  It would be an economic boon to Vietnam.  It would provide us with a partner in the area, that we lost after the Philippines kicked us out.  It would allow us a base of operations in the South China Sea, and to be able to counter any threat from the Chinese [or the Russians?].

Just a word of caution to future US Military who may visit the Danang area…don’t eat local, especially the seafood, and don’t drink the water. 

On the other hand, we have visited several Senate offices, and several House offices, and made some inroads into co-sponsorship in the House.  We still await the very cautious Senators' responses to visits as far back as mid-June. 

We are pressing on in both houses. 

In late June we had the distinct honor to make a presentation to the Institute of Medicine’s Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Ninth Biennial Update), and asked them to gain approval and find the funding for a proposed Mortality and Morbidity Study Among Vietnam and Vietnam Era Veterans.  The study would provide an expansive body of data about all who served during that time, and a control group of men and women of the same age that did not serve.  It is divided by where you served, and asks simply, what diseases have you been diagnosed with, and is not limited to the current list of Agent Orange diseases.  The Membership of the Veterans Association of Sailors of the Vietnam War have kindly offered most of them as participants in the study, should it come about.  We have had no feedback on it, but it seemed to be received with interest. If they do take on the study, and it comes out the way we suspect it will, Congress will not like it because it will mean enormous increases in the VA budget, and the VA will simply not like it either, having spent the past 45 years fighting tooth and nail to deny those benefits to all. 

Stay tuned.  Congress is in recess, and September-October will be hectic with the approach of the election. 

VNVets

”It is a stain on this nation's honor that the Department of Veterans Affairs has become a deadlier and more difficult adversary to the American veteran than any they have ever faced on a battlefield."-- VNVets

"The concept that Agent Orange, and its effects, stopped dead in its tracks at the shoreline is simply too illogical, and too ludicrous to accept. What does that say about the Obama Administration and his Department of Veterans Affairs?"--VNVets

"With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation's wounds; to care for him who shall have borne the battle, and for his widow, and his orphan--to do all which may achieve and cherish a just and lasting peace, among ourselves, and with all nations." --President Abraham Lincoln

"It follows then as certain as that night succeeds the day, that without a decisive naval force we can do nothing definitive, and with it, everything honorable and glorious."--President George Washington

Copyright © 2005-2012: VNVets Blog -- Now in our Eighth Year of Service to Veterans; All Rights Reserved. Reprinting or copying of the contents of this blog without the express permission of the author is unlawful.