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Dear Readers
Though the commission raised the question of Gulf War Illness
presumption by September 2005, the commission isnt addressing
it publicly.
I talked with Ray Wilburn of the VDBC this morning and asked a
variety of questions.
First addressed was timeline of the VDBC, and the intent is to
send recommendations to the IOM within 15-17 months from the
first meeting. That was May 9-10th 2005.
Then I asked had the committee discussed Gulf War presumption?
His explanation was not really. ( keep in mind I pointed out to Ray
and several committee members about PL 105-386 presumption
issues - Title 38 SS 1117 / 1118 in August 2005 )
Qoute:
"Presumption of service-connection now includesvaccinations against certain biological war hazardsin preparation for operations in the Persian Gulf."In fact, neither Congress nor VA has created any such presumption.VA Disability Compensation Program - Legislative History
http://www.va.gov/opp/eval/Disability_Comp_Legislative_Histor_Lit_Review.pdfLegislative History for the VA Disability Compensation Program
Part of my arguement on this had been that we set laws in place for
presumption of undiagnosed Illness, and VA changed its policy about
undiagnosable conditions. That not only do they stress diagnosis, but
tries to establish conditions as congenital or pre-existing.
Then came up the question of how does the IOM conduct its research
into any of this. I tried to discuss the handling of Gulf War by the IOM
and its review process. Then Ray defended the IOM, which alarmed
me.
Im really having my doubts at this point that the committee will get
any further than just mentioning these issues. That is, unless Gulf
War veterans start showing up to dispute this.
Next meeting is this Friday at the Cannon Buidling, people should
try to attend since its public.
Sincerely
Kirt P. Love
Director, DSBR
Should the Commission review the Gulf War Illness
presumptions?
Public meeting will be October 14, 2005, from 9:00 am to 4:00 pm
in the hearing room of the House Committee on Veterans' Affairs
located in room 334 of the Cannon House Office Building,
(one block north of the Capitol South Metro Station on the Orange
and Blue Lines), in Washington, DC 20515.
3. To what extent, if any, should VA policies relating to presumptive conditions
be changed?
(Ref: 38 CFR 3.309): Certain diseases shall be granted service connection although not
otherwise established as incurred in or aggravated by service if manifested to a
compensable degree within the applicable time limits under §3.307 following service in
a period of war or following peacetime service on or after January 1, 1947, provided the
rebuttable presumption provisions of §3.307 are also satisfied. A presumptive condition
is an injury or illness in which VA presumes a relationship exists between service and
the conditions being claimed. A recurring theme within the compensation program has
been the expansion of the definition of service connection, mainly under the
presumption basis. Is the current process to determine whether a disease should be
recognized by VA as a presumptive condition appropriate?
Agent Orange, Radiation and Gulf War Syndrome have resulted in a rapidly growing
area of environmental presumptions that have prompted some to raise questions about
the disability compensation program. War often affects men and women in profound
ways that are not easily explainable or treatable. Many veterans experience
problems/diseases that they attribute to chemical or radiation exposure. Leaving aside
questions of the possible effect of psychic injuries inflicted by war on these questions,
science cannot easily or quickly resolve these issues particularly where
(1)chemical/radiation exposure levels are often unknowable or difficult to ascertain and
(2) the effect of exposure on diseases experienced is scientifically unsettled.
Notwithstanding this uncertainty, the intense emotions surrounding those genuinely
suffering and the perceived unfairness of forcing veterans to "prove" their situation is
related to their possible exposure has led Congress and the Executive Branch to create
presumptions. If certain studies, for example, (not even necessarily involving veterans)
show that those exposed to dioxin have slightly higher rates of diabetes or prostate
cancer, there is an inexorable push to compensate all veterans with diabetes/prostrate
cancer even if it is likely that dioxin exposure is a determinative factor in only a small
percentage of cases. Since it is impossible to know what role dioxin played in any
particular case, all diabetes and prostate cases are compensated.
Consultation with Institute of Medicine (IOM) about levels of exposure and how they are
determined might be able to refine and enhance the process. Currently everyone who
served in Vietnam is presumed to have been exposed to dioxin from Agent Orange.
This presumption was created because of a lack of information. Has that changed? Do
we have a better way of making these determinations?
Should VA consult with IOM to see if a different methodology should be used in
determining causal relationships other than the environmental aspect used for the
current method? Should the Commission review the Gulf War Illness presumptions?
Should the standards for inferential statistical evidence in finding an association
between causative factors and disabilities change?
Public Law 108-136 which established the Veterans’ Disability Benefits Commission
requires that the Commission compare veterans’ disability benefits with benefits
provided to individuals by the Federal Government, State governments, and the private
sector 13 . Public Law 108-375 requires that the DoD conduct a study that compares
disability benefits for members of the Armed Forces with commercial and other private-sector
disability plans
Accountability Office (GAO) conduct a study of the disability benefits for employees of
the Federal, State, and local governments.
15 The GAO study is to pay particular
attention to jobs in which employees perform tasks with risks analogous to the risks
associated the performance of military tasks by members of the Armed Forces.
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