After cancer diagnosis, vet refutes government’s Agent Orange expert — and wins (ProPublica)
For years, the U.S. military and Department of Veterans Affairs have used the work of a Wyoming-based herbicide expert to flatly reject the claims of groups of veterans who believe Agent Orange made them sick. But occasionally, individual veterans have fought back — and even more rarely, they have won. One of them is Air Force veteran Phil Cacioppo. In 2007, Cacioppo was diagnosed with a rare form of non-Hodgkin lymphoma. He assumed he’d be approved for cash compensation and to receive treatment at VA hospitals. After all, he believed he’d been exposed to Agent Orange while he served as a ground radio equipment repairman at the U-Tapao Airfield in Thailand from 1969 to 1970. And his type of cancer had been associated with the herbicides used during the Vietnam War. But Cacioppo’s claim for benefits was denied, at least in part based on the research of Alvin Young, the government’s oft-chosen expert, records show. “U-Tapao Airfield is not on the Department of Defense listing of herbicide spray areas and test sites outside the Republic of Vietnam,” the VA’s St. Louis Regional Office wrote in its 2011 claim denial. While the denial letter didn’t cite Young, it relied on the conclusions of a 2006 report he wrote under contract for the Pentagon. In it, Young said many veterans confused commercial herbicides, used on many bases to kill weeds, with the stronger “tactical herbicides,” including Agent Orange, which were used in combat. In his appeal to the Board of Veterans’ Appeals, Cacioppo argued that there was no evidence that the military distinguished between tactical and commercial herbicides. In 2012, the board sent the claim back for further consideration, noting “the Veteran’s contention that a distinction between tactical and commercial herbicides did not exist in records published during the Vietnam era.” Cacioppo, 70, a semi-retired engineer in Kansas City, Missouri, ultimately won his claim in 2013. The VA didn’t mention Agent Orange, but said he’d been exposed to herbicides and deserved benefits. “We have conceded your … exposure to herbicide agents while stationed in Thailand,” the VA wrote in granting him 100 percent disability. “Our review of the multiple lay statements and military and VA documents contained within your claims folder provided us with enough credible evidence to determine you conducted military duties near the air base perimeter.” The VA had previously determined that extremely strong herbicides of some sort had been sprayed there. In a 2013 report for the VA, Young criticized the VA’s decision to grant such benefits, saying it ran counter to the evidence he found. Cacioppo ended up receiving compensation dating back to 2007, when he first filed a claim, but he blames Young for the delay, which kept him from having his cancer treatment and expensive medications covered at VA hospitals until 2013. “This report by Alvin Young has been used often to deny ill veterans benefits that were stationed in Thailand such as myself,” he wrote to the VA in May 2013. Cacioppo has contributed to a website to help other Thailand veterans win benefits — and overcome Young’s contentions. “I don’t think it should have been that hard,” he said in a recent interview.
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Ash Carter suspends California Guard bonus repayments (Politico)
Defense Secretary Ash Carter has suspended collections and ordered a review of the process that’s forcing members of the California National Guard to repay enlistment bonuses that may have been paid improperly. In a statement issued Wednesday, the Pentagon chief called the process “unfair to service members and to taxpayers.” Story Continued Below “First, I have ordered the Defense Finance and Accounting Service to suspend all efforts to collect reimbursement from affected California National Guard members, effective as soon as is practical,” Carter said. “This suspension will continue until I am satisfied that our process is working effectively.” Carter also directed a Pentagon team to study the issue and establish a new process by the beginning of the new year to resolve the cases quickly and equitably. “The objective will be to complete the decision-making process on all cases as soon as possible — and no later than July 1, 2017,” Carter said. At the White House, press secretary Earnest applauded the moratorium. “The president has been pleased to see in the last 24 hours the Department of Defense make some specific commitments to ensuring that our service members are treated fairly,” Earnest told reporters. “We certainly want to avoid a situation where service members are punished because of nefarious or fraudulent behavior by someone else.” The move comes after days of uproar caused by the revelation that the Pentagon had been seeking repayment of enlistment bonuses erroneously paid to Guard members, with most cases occurring in California. Numerous California lawmakers — including House Majority Leader Kevin McCarthy, Minority Leader Nancy Pelosi and Sens. Barbara Boxer and Dianne Feinstein — have urged the Pentagon to halt the repayments or proposed legislative fixes. Carter’s decision to suspend the forced repayments drew mostly praise, though many of the most vocal critics of the Pentagon’s actions indicated Congress may still act to make whole individuals who already paid back their bonuses. “I’m glad the Pentagon came to its senses,” House Speaker Paul Ryan said, adding, “Congress will continue to work on any reforms necessary to ensure this doesn’t happen again.” “Secretary Carter’s decision to order the Defense Department to suspend its clawback of Californians’ decade-old enlistment bonuses is welcome news,” Pelosi said. “However, we must work to permanently lift the shadow of these clawbacks and address the burden on those who have already been forced to return bonuses they accepted in good faith.” House Veterans’ Affairs Chairman Jeff Miller (R-Fla.), however, slammed Carter’s response as “weak and ham-handed,” adding the moratorium on recouping bonuses doesn’t cover potential problem cases outside of California. “Carter seems to have no plan to make those who’ve already been forced to pay back their bonuses whole, and by focusing only on the California Guard, he is ignoring what media reports indicate could be a national problem,” Miller said. “Once again, it seems Congress will be forced to fix a problem that the Obama administration created but refuses to fully address on its own,” he added. House Armed Services Chairman Mac Thornberry (R-Texas) and Senate Armed Services Chairman John McCain (R-Ariz.) also plan on including a fix to the bonus issue in the final version of the National Defense Authorization Act, according to an aide. “Chairman Thornberry and Sen. McCain are discussing how they could adjust NDAA provisions to fix this issue,” the aide told POLITICO.
GAO says Pentagon needs to do more about burn pit exposure (Military.com)
The Pentagon needs to study the long-term health effects of exposure to the chemicals inhaled from burn pits at its overseas military bases, the Government Accountability Office says in a report. While the report, released in September, credited the Department of Defense with improving practices to mitigate the risks of exposure to the burn pits, the department still needs to ensure that “research specifically examines the relationship between direct burn pit exposure and long-term health issues.” The GAO found there hasn’t been enough progress on this issue over the past five years, when it first said more study was needed. “The current lack of data on emissions specific to burn pits and related individual exposures limits efforts to characterize potential long-term health impacts on service members and other base personnel,” the report warned. Open-air burning has always been a mainstay of waste disposal during times of war. But the technology of modern warfare means that such new items as plastic bottles and electronics are being burned, presenting new health risks. Burn pits were constructed at more than 230 U.S. military bases across Iraq and Afghanistan before their use was restricted in 2009. Although the military gave assurances that the air quality was within safe levels, troops returning home began complaining of problems as early as 2004. Massive open-air burn pits at the bases billowed the toxic smoke and ash of everything from Styrofoam, metals and plastics to electrical equipment and even human body parts. The flames were stoked with jet fuel. While it took nearly three decades for the U.S. government to eventually link Agent Orange, the defoliant used in Vietnam, to cancer, President Obama has pledged quick action to make determinations about the effect of the burn pits on perhaps as many as 60,000 U.S. troops. A 2011 report by the Institute of Medicine outlined the data needed for assessing exposures and potential related health risks. In response, the Department of Veterans Affairs established a registry to collect information. However, the Department of Defense has not undertaken data-gathering and research efforts to specifically examine this relationship to fully understand any associated health risks, the GAO report said. To date, the VA’s official position is that research has not established evidence of long-term health problems from exposure to burn pits. The magnitude of the issue, however, may not be clear for decades as delayed war casualties slowly emerge. In Minnesota alone, it is estimated that more than 14,000 Minnesota Army and Air Guard troops qualify to be part of a national registry for potential burn pit exposure, based on where they were stationed during deployments. The Star Tribune recently documented the plight of Minnesota Air National Guard veteran Amie Muller, who is battling pancreatic cancer and several other maladies after returning from deployments to Balad Air Base in Iraq, site of one of the most notorious military base burn pits. Despite the mounting public outcry from vets, their families and members of Congress, the VA continues to say research does not show evidence of long-term health problems, and that most irritation is likely temporary. U.S. Sen. Amy Klobuchar has proposed a national center to study the long-term affects of burn pits. While generally agreeing with the GAO report, the Pentagon said the report should have acknowledged research that the Department of Defense already has completed with other organizations.
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Opiate prescriptions down at the VA, alternatives on the rise (Reveal)
The Department of Veterans Affairs is doling out narcotics to 160,000 fewer veterans than it was three years ago, a reduction of nearly 25 percent, and alternative treatments are on the rise. Government prescription data also shows that the number of veterans receiving prescriptions for both a narcotic and a tranquilizer, a combination that often leads to overdose, has been cut in half. Although some veterans complain that the alternatives remain sparse, experts say the change – which followed a 2013 investigation by Reveal from The Center for Investigative Reporting – is likely saving lives. “This is a big story,” said G. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. “One would expect large reductions in the number of veterans experiencing addiction and overdose.” The drop in opiate prescriptions occurred even as the VA added nearly half a million patients, many of them younger veterans returning from Iraq and Afghanistan. Reveal’s coverage exposed a dramatic rise in the number of opiate prescriptions at the agency and a fatal overdose rate among VA patients of double the national average. Veterans say they’ve noticed the change. “When I first got back they would send me to a doctor, and he would just ask me, ‘Hey, is there a medication that you would prefer?’” said Vince Emanuele, 32, a Marine Corps veteran who served two tours in Iraq. “People were being prescribed an absurd amount of drugs.” Now, Emanuele said, when he goes to his local VA hospital in Northern Indiana, he’s offered transcendental meditation or yoga, counseled on his nutrition and exercise regimen, and queried about the strength of his social network. “It’s much different than: Let’s give you medication, and I’ll see you in 60 days,” he said. Still, many veterans also complain that the VA cut down on narcotics without a commensurate boost in alternatives. The result, said Anthony Hardie, director of the advocacy group Veterans for Common Sense, is that veterans often face long waits for treatment and remain in excruciating pain. “Pain is now,” Hardie said. “People don’t call up and say, ‘Hey, I might get pain in three weeks.’” In an email, the VA said it had trained 1,000 providers in “Battlefield Acupuncture” and now employs chiropractors at about half of its hospitals. Classes on stress management and relaxation are available at 112 VA facilities, the agency said, while the number of hospitals offering tai chi or yoga has doubled. Hardie, a Gulf War veteran who battles neck pain, knee pain and fibromyalgia, said he was offered chiropractic treatment by the VA. But since the closest hospital is a nearly two-hour drive from his home in Bradenton, Florida, accessing that care would mean missing work. This July, President Barack Obama signed sweeping narcotics reform legislation that further regulates the way the VA dispenses and monitors opiates. The Jason Simcakoski Memorial Opioid Safety Act was prompted by a Reveal investigation published in January 2015. The story disclosed that veterans at the VA hospital in Tomah, Wisconsin, showed up to appointments stoned on prescription painkillers and muscle relaxants, dozed off and drooled during therapy sessions, and burned themselves with cigarettes. The law, named after a veteran who died in the Tomah hospital’s psychiatric ward, created stronger opioid prescribing guidelines for VA providers, including stricter standards against prescribing narcotics in combination with other drugs such as tranquilizers, and restrictions on prescribing opiates to patients with mental health issues. Alexander, with Johns Hopkins, commended the VA for moving faster than the private sector to address the national epidemic of painkiller addiction. But the legislation’s requirements for oversight of progress toward goals and alternative therapies will be key. “It’s important that these changes be enduring,” he said.
VA loans hard to qualify for, veterans say (WFTV)
A special benefit created to save military veterans big money when buying a home isn’t getting used as much as one might expect. One local veteran told Channel 9’s Nancy Alvarez about the obstacles she encountered in using her VA loan. Alvarez looked into the federally backed process to figure out what was chasing sellers away. Brittany Chaney is a single mother and Navy veteran who wants to use a VA loan to buy a new home. But Chaney applying for the VA loan is a time hassle. “It’s gonna be time consuming. It’s not going to be easy, you’re going to be disappointed,” Chaney said. VA appraisers follow what’s called, “Safety, soundness and sanitation” guidelines that go way beyond what’s required for conventional loans, and even the federally backed FHA loans. Examples include a home’s roof, which has to be within its useful life or must be replaced or repaired. Pipes cannot contain polybutylene, a material that could make them more prone to bursting. VA inspectors are also required to report even the smallest amount of evidence of dry rot, termite or pest-control problems. “The inspection process and appraisal process is more stringent to protect the veteran,” said Keith Jackson, education director for Veterans Association of Real Estate Professionals, or VAREP and said it’s not uncommon for some realtors to steer their clients away from VA loans. Jackson told Eyewitness News that his group’s analysis of the local real estate market shows another layer to the problem. In Orlando, more than 75 percent of the condos on the market right now won’t accept a VA loan… “It’s a seller’s market, so they may have multiple offers and they may say, ‘I don’t want to deal with a VA loan because the transaction time will be longer or my house is not in a condition that will pass a VA inspection.’ so they say, “Hey, I’d rather not deal with that,’” Jackson said. Jackson said the fix is education and clearing up the misconception that VA loans are too much of a hassle. Chaney told Eyewitness News that she has no plans on giving up on her VA loan. “I earned these benefits. It’s not like we feel it’s owed to us, but why would you spend the extra money if you could save it?” Chaney said. Jackson said that at this time, the VA has no plans to loosen the requirements for the loans, even though it appears sellers tend to stay away from them, nationwide.
Alleged toxic condition at Providence VA blamed for health problems (WPRI)
A federal lawsuit filed by a Providence Veterans Affairs Medical Center doctor alleges “unsanitary and harmful” conditions that included mold, mice and toxic fumes in the hospital left him permanently injured, and allegedly put doctors, technicians and patients in danger. The 2013 complaint has been inching through the federal court system with close to 90 filings to date, including one just last week. Dr. William S. Naughton, who also has a podiatry practice in Warwick, filed the lawsuit along with technician Maria Horridge, claiming a $12 million construction project that was completed in 2014 sent damaging, noxious fumes and dust into the VAMC Podiatry Clinic. The lawsuit alleges complaints to hospital administrators in 2012 about fumes, headaches and nose bleeds were ignored. Money was said to be the motive to keep the clinic going despite a recommendation to shut it down until it could be moved. According to the document, a VAMC employee stated the hospital administration at the time of the project did not want to stall the financial impact of the busy clinic. “The administration wanted the clinic to continue generating revenue,” the lawsuit indicated. “The revenue fueled the bonuses of the hospital administrators.” In its answer to the complaint, the VA denied those claims. The lawsuit said the situation “worsened” as time went on, with the project causing “large amounts of dust” and more toxic fumes to spew into an area of that also had issues with mold, mice and worse, according to the lawsuit. “Blood and portions of human tissue remained on the floor and equipment for days if not longer,” the lawsuit stated. Along with the Department of Veterans Affairs, contractors Gilbane Building Company and Legion Construction are named in the lawsuit, and M. Disandro and Sons Masonry is posted as a third-party defendant. The attorneys for the contractors chose not to comment, and the attorney for the plaintiffs made the same decision. Providence VAMC Public Affairs Officer Winfield Danielson would not comment on the specifics but said in a statement, “We conduct a risk assessment for every construction project, evaluating it for infection control, and other health and safety factors.” Danielson said measures are instituted when required. “I want to emphasize that the health and safety of our Veterans and staff is our foremost concern,” Danielson said. “[That] directly affects our mission of providing exceptional and accessible care for Veterans.” An email that is one of the exhibits in the case indicated VAMC Infection Preventionist Maria Trice inspected the rooms in the clinic and informed Clinic Podiatrist Dr. John Simoes about her concerns. Trice told Dr Simoes she was worried about “infection control” in the podiatry facility. “We have asked that the Podiatry clinic be moved ASAP,” Trice wrote. “Or if no space is found, to shut down the clinic until adequate space is found.” According to the plaintiffs, the clinic was not moved as the construction project continued. The lawsuit stated the “substance in the air caused one physician to bleed readily from his nose,” with others in the clinic suffering from headaches, metallic tastes in their mouths and burning eyes. Dr. Naughton claims he now suffers from “chronic obstructive pulmonary disease” that another doctor said could be permanent. Horridge also has “suffered permanent disability and other harm” according to the lawsuit, which indicated the plaintiffs are seeking damages “exceeding” $400,000.
VA Inspector General to investigate wait lists at Gardner, Johnson’s request (The Ripon Advance)
U.S. Sens. Cory Gardner (R-CO) and Ron Johnson (R-WI) recently welcomed news that the Inspector General of the Department of Veterans Affairs (VA) would investigate reports of wait lists for care. Gardner and Johnson requested the investigation in September after a whistleblower reported a wait list for care that contributed to the suicide of a veteran awaiting treatment for post-traumatic stress disorder at a Cold Springs, Colorado, VA facility. VA Inspector General Michael Missal recently announced that his office would heed the senators’ request for an investigation. “I welcome the inspector general’s review of potential unauthorized wait lists and falsification of documents at VA facilities in Colorado,” Gardner said. “These allegations are serious and therefore must be met with a thorough, comprehensive investigation. I remain committed to fighting for transparency and accountability from the VA, and I look forward to reviewing the inspector general’s findings.” Johnson, the chairman of the Senate Homeland Security and Governmental Affairs Committee, said he appreciated Missal opening an investigation into the report of “secret wait lists to manage veteran care.” “As we’ve seen at VA facilities in Wisconsin, it is vital that allegations of wrongdoing at VA facilities be investigated promptly and thoroughly,” Johnson said. “Our veterans, the finest among us, deserve the best quality care. I look forward to reviewing the IG report when it is complete.” Gardner and Johnson also requested an investigation of reports that documents pertaining to the Cold Springs veteran suicide had been falsified.
Oregon to receive $500,000 to help veterans in 10 rural counties (The Register-Guard)
The Oregon Department of Veterans’ Affairs said Monday that it will receive grants worth a combined $500,000 to provide free transportation to medical appointments for military veterans living in 10 rural counties. The money from the state Department of Veterans’ Affairs will go to transportation agencies in Baker, Gilliam, Grant, Lake, Harney, Malheur, Morrow, Sherman, Wallowa and Wheeler counties, all of which have a population density of fewer than seven people per square mile. Nearly 9,500 veterans live in the Oregon counties, and many must travel hours for treatment at Veterans Affairs medical centers in Bend, Portland, Roseburg and other cities, said Tyler Francke, a spokesman for the state Veterans’ Affairs Department. Oregon has secured the grants since 2014. The first year, it received $400,000 because only eight counties participated, but in 2015 Lake and Harney counties joined the program and the state netted $500,000 — a maximum of $50,000 for each county, he said. “When you’re talking about these counties, really no matter where you’re going, you’re looking at a pretty big trip,” he said. In Wheeler County, Oregon’s least populous county with just 1,441 people, the grants help Wheeler County Community Transportation provide service to 33 veterans who range in age from 75 to 95, said Linda Glawe, a dispatcher. The drivers are all volunteers, she said, and trips to veterans medical centers can easily make for a 14-hour day. Some riders try to donate $5 or $10 for the lift, but most live on limited incomes, she said. The grant money helps make up the difference when one trip can mean $60 in gas alone. “It’s a blessing because it helps us stay afloat,” Glawe said. Last year, programs in the 10 participating counties logged more than 274,600 miles and spent 9,871 hours on the road, Francke said. The 5,453 trips accounted for nearly half of the trips provided nationally under the Veterans Administration’s Highly Rural Transportation Grant program, he added. Nearly 300 counties in 25 states qualify as highly rural counties and can apply for the grant money.