AACE: Agent Orange Ups Some Thyroid Risks
By Kristina Fiore, Staff Writer, MedPage Today
Published: April 26, 2010
Reviewed by Dori F. Zaleznik, MD
; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
§ Explain that veterans who'd been exposed to Agent Orange were three times more likely to develop Graves' disease, but were not at greater risk of other thyroid disorders including cancer or nodules.
§ Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered preliminary until published in a peer-reviewed journal.
BOSTON -- Vietnam veterans who came in contact with Agent Orange are more likely to develop Graves' disease than those who avoided exposure, researchers said here.
The autoimmune disorder was three times more prevalent among veterans who encountered the dioxin-containing chemical, Ajay Varanasi, MD, of SUNY Buffalo, and colleagues reported at the American Association of Clinical Endocrinologists meeting here.
"We also looked at other [thyroid] diagnoses," Varanasi told MedPage Today, "but we didn't find any significant differences in thyroid cancer or nodules."
Varanasi and colleagues originally hypothesized that the latter two diagnoses may be more prevalent among vets exposed to the toxin.
Agent Orange was a defoliant sprayed from U.S. planes and helicopters during the Vietnam War to deprive Viet Cong and North Vietnamese soldiers of cover. Veterans have long complained that exposure to the chemical caused them a variety of health problems, though few have been confirmed.
Since most Vietnam veterans have been assessed for possible Agent Orange exposure, the researchers were able to review their records and correlate that with disease.
In 2008, they assessed the prevalence of major thyroid diagnoses in the Veterans Affairs (VA) electronic medical record database beginning in 1996 for veterans born between 1925 and 1953 who were treated in a VA network in upstate New York.
They compared the frequency of diagnosis with thyroid cancer, nodules, hypothyroidism, and Graves' disease in both exposed and nonexposed populations.
A total of 23,939 vets had been classified as exposed to Agent Orange, while 200,109 were not exposed.
The researchers found that the prevalence of Graves' disease in those exposed to Agent Orange was three times that of the unexposed group (OR 3.05, 95% CI 2.17 to 4.50, P=0.001).
The relationship remained even after multivariate analyses accounted for potential confounders such as smoking (OR 2.76, 95% CI 2.22 to 3.81, P<0.001).
Interestingly, Varanasi said, prevalence of hypothyroidism was lower in those exposed to Agent Orange. Nor was there any difference in the prevalence of thyroid cancer or nodules between those exposed and those not exposed.
"There's no real mechanism as to why it should cause a high prevalence of cancer," Varanasi said.
But the literature holds a likely mechanism linking exposure to Graves' disease, he added.
"In doing a literature search, we found that the dioxin in Agent Orange might have some immune-modulating effects in human beings," he said.
This dioxin -- 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) -- binds to aryl hydrocarbon receptors (AhR) very tightly, leading to prolonged activation of genomic and nongenomic metabolic disorders, the researchers said.
In mice, for example, AhR can regulate the differentiation of regulatory T cells and of T cells that produce interleukin-17. Also, AhR ligands like TCDD can modulate autoimmunity.
"The effects could be through this hydrocarbon, and this receptor is mainly expressed in T-helper-17 cells," Varanasi said. "Through this mechanism, we could have some immune modulating effects, and this could cause a higher prevalence of Graves' disease in exposed patients."
He and colleagues concluded that the relationship of Graves' disease to Agent Orange exposure warrants further investigation.
The researchers reported no diclosures.
Primary source: American Association of Clinical Endocrinologists
Source reference:
Varanasi A, et al "Are veterans exposed to Agent Orange more likely to get Graves' disease?" AACE 2010; Abstract 1046.
Wednesday, April 28, 2010
AACE: Agent Orange Ups Some Thyroid Risks
Post-Traumatic Stress Disorder Cases Rise in German Soliders in Afghanistan
Post-Traumatic Stress Disorder Cases Rise in German Soliders in Afghanistan
One Psychiatrist for 4,500 Troops
The Germany armed forces' deployment in Afghanistan appears to be having an impact on soldiers' psyche. Several newspaper reports claim the number of cases of post-traumatic stress disorder is on the rise. And the Bundeswehr lacks psychiatrists to provide the necessary treatment.
The number of Bundeswehr soldiers affected by psychiatric problems has increased rapidly in recent months, with the number of those suffering from so-called post-traumatic stress disorder having risen particularly quickly, two German newspapers reported on Thursday.
Both of the dailies, the Rhein-Zeitung and the Süddeutsche Zeitung, referred to a request for information made to the defense affairs committee of the German federal parliament by politician Elke Hoff of the Free Democratic Party (FDP). "Up until now the government has neglected to do anything to better the psychological care and treatment of soldiers," she told the Süddeutschen Zeitung.
According to the newspapers, the number of soldiers suffering first symptoms of post-traumatic stress disorder had risen by over 30 percent in the first six months of 2009. This resulted in a total of 163 cases. Last year, a total of 245 cases of the psychiatric disorder were reported in the military, with 226 of them occurring in Afghanistan. In 2006, only 55 soldiers were diagnosed with post-traumatic stress disorder. During the past six months, attacks on German forces in Aghanistan have risen.
More Mental Health Care Urgently Needed
Hoff brought up the issue because of the findings of a study she commissioned from German military psychiatrist, Mario Horst Lanczik. He spent time in Afghanistan examining soldiers with PTSD and found that the psychiatric care of German soldiers was not adequate either before, during or after combat. Hoff also pointed out that there are not enough psychiatrists available in the military to provide the necessary support. Only half of the 40 potential positions for psychiatric support in the military's medical corps are currently filled. And there was only one psychiatrist available to the 4,500 German troops in Afghanistan.
According to the Rhein-Zeitung newspaper, two therapists are available directly to soldiers in the Hindu Kush. The Bundeswehr has said that they are part of a network of pastors and army doctors.
Hoff is now demanding more mental healthcare options for German soldiers. She told the Rhein-Zeitung that she wants the empty positions in the medical corps filled and she has said that psychiatric problems following military deployment abroad should not be stigmatized as a hindrance to a career in the army. If this was the case, then soldiers might be tempted to hide their problems, she noted.
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It appears that the American Army and other military forces are the only ones to have problems getting enough mental health care available in the war theater and back at the troops home bases. This is an issue that is not going to go away, as long as troops are in war zones there will be stress related issues and either the troops get treatment early or they will do much like they do now, suck it up, ignore it because they fear it will harm their careers by asking for help, or wait decades like many Vietnam war veterans before they have a melt down.
Tuesday, April 27, 2010
Official Calls Wounded Warriors Report ‘Unrepresentative’
Official Calls Wounded Warriors Report ‘Unrepresentative’
By John J. Kruzel
American Forces Press Service
WASHINGTON, April 26, 2010 – The focus of a New York Times article depicting neglect and suffering endured by a group of wounded soldiers recovering in an Army program is unrepresentative of the recovery effort at large, the Army surgeon general said today.Video
Lt. Gen. (Dr.) Eric B. Schoomaker stopped short of calling the article that appeared yesterday inaccurate, but said the overwhelming majority of soldiers in warrior transition units are satisfied with the recovery regimen, according to an Army survey.
“I don't see them as necessarily crafting fiction,” Schoomaker said to Pentagon reporters about the article. “But I do believe that it is wholly unrepresentative of the totality and the context of what we’ve done for warrior care, especially in the last three years.”
Overall, 81 percent of participating soldiers are satisfied with the program, and about 90 percent of wounded soldiers recovering at Fort Carson, Colo. -- the focal point of the New York Times article -- are satisfied with their warrior transition unit according to the survey, Schoomaker said.
These figures paint a picture in stark contrast to the New York Times report, which the paper said was based on interviews with more than a dozen soldiers and health care professionals from Fort Carson’s transition unit and reports from other Army posts. The article states that warrior transition units have become “warehouses of despair” for many soldiers.
The Army surgeon general took umbrage at this portrayal of warrior transition units -- which are responsible for some 9,300 soldiers -- calling it “a poor characterization” and “almost 180 degrees of the truth.”
Schoomaker was asked specifically to comment on the report’s description of the units as “warehouses of despair, where damaged men and women are kept out of sight, fed a diet of powerful prescription pills and treated harshly by noncommissioned officers.”
“Of all of the descriptions in there, with the exception perhaps of the suffering that individual soldiers and families have had,” he said, “that sentence alone is among the most offensive to us. And I think it wholly describes a situation that we feel is not present.
“We welcome you and any member of the press to go out and physically visit warrior transition units,” he continued, “to talk with those soldiers, to talk with their cadre and to see the larger context of how care is being delivered.”
The article raised concerns about the over-prescription of drugs by doctors and the abuse or misuse of both prescribed and illicit substances. A military official told reporters that 78 incidents of illegal drug use have been recorded at the Fort Carson warrior transition unit since 2008.
“We have concerns about the diversion of prescription drugs that can be used for recreational uses, just as in the nation at large,” Schoomaker said. “That's a big problem right now across the country. We’re also concerned because illegally obtained drugs can be used as complements to these other drugs.”
Schoomaker said an inspection of warrior transition units by the Army inspector general will be completed soon, and Army Brig. Gen. Gary Cheek, commander of Warrior Transition Command, is slated to visit Fort Carson to review policies and practices of their warrior transition unit later this week.
“With 9,300 soldiers currently in the program, we don't always get it right,” Schoomaker said. “To that end, we take every criticism and concern seriously and continuously strive to improve our program.”
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The Warrior Transition Units were created with the purest of goals when they came into being, it was because the old "medical holding companies" of the past just were not doing a job of maintaining control over the ever growing number of wounded veterans filling the nations military hospitals that were not bad enough to still be hospitalized but not well enough to return to their units. Most will be given medical discharges due to PTSD and or amputations or other significant wounds. The majority of these soldiers are on so much medication that actually showing up for formations atregular times can be more than should be expected. Many are "zombies" from the narcotics the hospitals are giving them, or anxiety medications, etc, many of them are walking pharmacies, hardly capable of doing "work" of any meaningful type, yet the chain of command are writing these soldiers up for missing formations, reducing their ranks, taking away part of their paychecks and by the time many of their medical discharges are ready to be processed these soldiers have found themselves in so much disciplinary problems that instead of getting a medical discharge they are being thrown out of the Army on bad conduct discharges and finding themsleves owing the military thousands of dollars in over payments of enlistment or re-enlistment bonuses, which makes the depression even worse.
Last week they were hero's this week they are zero's and owe the Army they served honorably at war. Yes there is a requirement for discipline even for soldiers in medical treatment for war injuries but throwing a wounded soldier out of the Army with no medical benefits and a bad discharge which will now prevent them from getting even the basic care at the Veterans administration or being able to file for veterans compensation for their injuries, you have some very depressed veterans left kicked to the curb. There needs to be a lot more leeway given to these type of soldiers, they are not infantry troops training to go to war, they have been there and injured now they need help and compassion not to go thru a version of hospital boot camp and see who survives with all the stripes they arrived with.
VA refuses to make ASST Sec Tammy Duckworth available
The text of Mitchell’s letter to Shinseki is below:
April 23, 2010
Honorable Eric K. Shinseki
Secretary
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420
Dear Secretary Shinseki:
I am concerned about what appears to be an emerging pattern of non-compliance by the Department of Veterans Affairs with recent Subcommittee requests for witnesses and information. Most recently and notably, I am concerned about the Department’s refusal to comply with our Subcommittee’s request to produce Undersecretary for Health, Dr. Robert Petzel, and Assistant Secretary for Public and Intergovernmental Affairs, L. Tammy Duckworth, to testify before our oversight hearing, Examining the Progress of Suicide Prevention Outreach Efforts at the U.S. Department of Veterans Affairs, that had originally been scheduled for April 28, 2010.
As you may be aware, on April 23, 2010, an Army Times article reported that there is troubling new data showing that there is an average of 950 suicide attempts each month by veterans who are receiving some type of treatment from the VA.[1] The subject of the hearing was to be outreach to all veterans – many of whom are not being treated by the VA – who have committed or attempted suicide.
As you know, our Subcommittee has long believed that the epidemic of veteran suicides, and the VA’s outreach efforts to veterans at risk are of paramount concern, and has held numerous oversight hearings on the subject.[2]
On Wednesday, April 21, 2010, we were told by Assistant Secretary of Congressional and Legislative Affairs that the Undersecretary for Health, Dr. Robert Petzel, and Assistant Secretary for Public and Intergovernmental Affairs, L. Tammy Duckworth, would not be complying with our request.
Our Subcommittee has an obligation, on behalf of our nation’s veterans, to examine the VA’s efforts to address this problem. We cannot, however, conduct our work without access to appropriate witnesses and appropriate information from the Department of Veterans Affairs. That is one of the reasons why our Committee is vested with subpoena power. [3]
I urge you to reconsider the Department’s response, and to produce the requested witnesses.
This most recent exchange follows the Department’s decision not to produce Deputy Secretary Gould to testify at the Subcommittee’s hearing on February 25, 2010, entitled Gulf War Illness: The Future for Dissatisfied Veterans. My first request was on October 26, 2009. Again on November 3, 2009, I reiterated the importance of having top leadership who can speak with necessary authority at the hearing. In my third letter, dated January 22, 2010, I stated my position yet again on the importance of Deputy Secretary Gould attending the hearing as a witness.
Instead, on February 18, 2010 we were informed that the Department would not comply with my request and had unilaterally decided to send Chief of Staff, John Gingrich, as a replacement.
As I am sure you are aware, Congress determines who testifies at hearings – not the Department of Veterans’ Affairs.
Moreover, I am also concerned that the VA has yet to return questions from our Subcommittee’s Acquisition Deficiencies hearing on December 16, 2009. Responses were originally due on February 23, 2010. We granted an extension until March 2, 2010. To date, however, we have yet to receive the VA’s response.
Unfortunately, this is not the first time I’ve expressed my concerns regarding requests going unanswered or unreasonably delayed.
Additionally, as Chairman, I have received complaints from other Members of Congress that their requests for information from the Department are going unanswered or unreasonably delayed. Based on our Subcommittee’s recent experience with the Department, I am hardly in a position to dispute them. I am concerned that perhaps what we are experiencing is a cultural problem stemming from a disregard for Congressional prerogatives evident through refusals to send specific requested personnel or waiting until the last minute to inform us they are unavailable, and not responding to the specific requests made through this Subcommittee.
The power of Congress to conduct investigations is inherent in the legislative process. The Supreme Court had held that this power is broad.[4] It encompasses inquires concerning the administration of existing laws as well as proposed or possibly needed statues. It includes surveys of defects in our social, economic or political system for the purpose of enabling the Congress to remedy them. It comprehends probes into departments of the Federal Government to expose corruption, inefficiency or waste.[5] Congress does not take this power lightly. As the Court has stated, it must be related to, and in furtherance of, a legitimate task of the Congress.
Because this tremendous power is trusted by the Constitution to Congress, it is unquestionably the duty of all citizens to cooperate with the Congress in its efforts to obtain the facts needed for intelligent legislative action.[6] The Supreme Court makes clear the duty of all citizens, and agency officials, that it is their unremitting obligation to respond to subpoenas, to respect the dignity of the Congress and its committees and to testify fully with respect to matters within the province of proper investigation.[7]
I ask that the VA share the same unswerving commitment that I know you do, and be rededicated to a teamwork approach. The American public and veterans demand accountability from the VA through their elected representatives.
I urge you to ensure that the Department responds to all Congressional requests in timely and forthcoming manner. Our veterans deserve nothing less than full accountability and transparency. In this effort, you have my support.
Sincerely,
HARRY E. MITCHELL
Chairman,
Subcommittee on Oversight
and Investigations
1 Rick Maze, 18 Veterans Commit Suicide Each Day, Army Times, April 23, 2010 (visited on Apr. 23, 2010) < http://www.armytimes.com/news/2010/04/military_veterans_suicide_042210w/>.
2 Media Outreach to Veterans, Before the Subcomm. on Oversight and Investigations of the House Vet. Aff. Comm., 110th Cong (2007); Media Outreach to Veterans: an Update, Before the Subcomm. on Oversight and Investigations of the House Vet. Aff. Comm., 110th Cong. (2008).
3 Rules of the House of Representatives, Subpoena power, Rule XI (m)(1)(B), (m)(3)(A)(i), (m)(3)(C); See Watkins v. United States, 354 U.S. 178, 187-8, 200-1 (1957); See also U.S. House of Representatives v. U.S. Dep’t of Commerce, 11 F,Supp.2d 76, 86 (D.D.C.1998) (“[I]t [is] well established that a legislative body suffers a redressable injury when that body cannot receive information necessary to carry out its constitutional responsibilities. This right to receive information arises primarily in subpoena enforcement cases, where a house of Congress or a congressional committee seeks to compel information in aid of its legislative function.”).
4 Watkins v. United States, 354 U.S. 178, 187-88, 77 S.Ct. 1173, 1 L.Ed.2d 1273 (1957).
5 Id.
6 Id.
7 Id. See also Committee on the Judiciary v. Harriet Miers, 558 F. Supp.2d 53.
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The last time I looked Congress has the wallet or checkbook that funds the VA and they have oversight responsibility, which means that the VA must make their executives or anyone else employed by them available to the House or Senate Committees that want to question them under oath at hearings, it is part of their jobs. The federal agencies can't say no we are not going to comply or no we ain't coming to your hearings, they must be held accountable if they are defying Congress with the blessing of the Secretary of the VA's approval then he must answer to Congress on why he won't make these officials available and on what authority does he base this on? Executive privilege does not extend to people this far down the list from the President, we are a nation of laws, and we can not have federal employees deciding that they just are not going to comply with Congress, if necessary these individuals either show up at the hearings or be fired it's that simple, they are public employees, some who have been selected by the President and confirmed by the Senate, but they are still accountable, to us the taxpayers, and given the fact that the subject of these hearings is about suicides of this nations veterans, it is appalling that the VA would refuse to help get to the bottom of the problem. Maybe they don't have the answers but they should not be the road block to trying to find better solutions to a problem that is harming this nations veterans and their families, suicide has no winners, only pain is left in the wake of each and every suicide.
Wednesday, April 21, 2010
Can the Peace Drug Help Clean Up the War Mess?
Can the Peace Drug Help Clean Up the War Mess?
SAN JOSE, California—Michael Bledsoe's story begins like that of many other Iraqi war veterans. In 2007, he was chasing insurgents through Anbar province when a roadside bomb exploded, breaking Bledsoe's back and both his feet. A former Army Ranger working as a security contractor, Bledsoe soon knew his high-paying military career was over.
Back home, Bledsoe (not his real name) felt angry almost constantly. Nightmares haunted him. He withdrew and became isolated. "It was a serious sense of loss," he says. His psychiatrist quickly diagnosed post-traumatic stress disorder (PTSD).
Despite months of talk therapy, the nightmares continued, and Bledsoe grew desperate. Then "something almost miraculous" happened, he says. An online search brought him to a unique study of the banned drug MDMA (3,4-methylenedioxymethamphetamine), well known as the street drug ecstasy. The 21-patient study, sponsored by the nonprofit Multidisciplinary Association for Psychedelic Studies (MAPS), launched in 2004 as the first U.S. clinical trial of a psychedelic drug in 35 years.
After several bond-building sessions with psychiatrist and study leader Michael Mithoefer and a co-therapist, Bledsoe swallowed a white tablet, donned eyeshades and reclined in Mithoefer's comfortable Charleston, S.C., office. Over the next eight hours, Bledsoe revisited the explosion and recounted the trauma to Mithoefer. After two more MDMA-assisted psychotherapy sessions, Bledsoe says his PTSD symptoms were "completely eliminated."
This weekend at a MAPS-sponsored meeting here, Mithoefer reported similar results for nearly all of the trial's participants. After two or three MDMA sessions, patients who received MDMA experienced huge drops in symptoms as measured by a standard PTSD scale. At baseline, study patients had an average Clinician-Administered PTSD Scale (CAPS) score of 79, but after MDMA-assisted therapy, CAPS scores dropped to 23.4 in the 13-person MDMA group, whereas an eight-person placebo group averaged a score of 60. (Later, seven of eight placebo patients chose to receive MDMA as well.)
The improvements appeared to endure, Mithoefer reported. After an average of 3.5 years, 13 of 16 patients remaining in contact with the researchers no longer met the criteria for PTSD. However, two of the patients "clearly relapsed," Mithoefer says. In addition, many of the patients returned to using antidepressants and other psychoactive medications, though the total number of prescriptions in the group was much lower than before.
Julie Holland, a psychiatrist in New York City who used to work at the James J. Peters VA Medical Center in the Bronx, says the data "look really great. It's amazing that when patients are done with therapy, they don't meet criteria for PTSD. I've never even seen that. It's a very big deal." If MDMA were legal, Holland added, she would "absolutely" use it in her practice.
Brain-imaging studies in healthy volunteers show that MDMA quiets the amygdala, an almond-shaped structure deep in the brain that some researchers call a “fear center” due to its central role in triggering strong negative emotions. MDMA also releases a flood of the brain messengers serotonin and dopamine while increasing blood levels of the hormones oxytocin and prolactin, which promote social bonding. This potent mix diminishes fear and defensiveness and boosts empathy and the desire to connect with others, says Holland, so “the therapy work goes faster and deeper.”
Veterans suffer very high rates of PTSD, according to surveys. One 2004 study in The New England Journal of Medicine estimated that up to 18 percent of Iraqi and Afghanistan combat veterans experience the disorder. "This is our way of trying to contribute to our moral obligations to our veterans," says MAPS founder and executive director Rick Doblin. He added that the U.S. Department of Veterans Affairs has rejected overtures from MAPS to work together on five separate occasions.
The U.S. Food and Drug Administration (FDA) has been friendlier to the group. This month, the agency granted MAPS permission to continue testing MDMA in 16 additional veterans with PTSD. But the road to full FDA approval is long and expensive, and Doblin anticipates five to 10 years of additional trials. He envisions eventually building a network of psychedelic therapy centers.
A dedicated network of therapists experimented with MDMA-assisted psychotherapy in the 1970s and 1980s before the U.S. Drug Enforcement Administration banned the drug in 1985. The next year, Doblin launched MAPS to revive psychedelic research, a movement that's now gaining steam. A dozen human studies of MDMA, LSD, a powerful African drug called ibogaine and psilocybin, from so-called "magic mushrooms," are now under way, testing the once-stigmatized drugs as treatments for not only PTSD, but also cluster headaches and addiction, as well as anxiety and depression in cancer patients.
Charles Grob, a psychiatrist at Harbor-UCLA Medical Center, dosed 12 end-stage cancer patients with psilocybin to test whether the experience could ease anxiety and help the patients cope with their diagnosis. Grob did not present his data, which are under review for publication, at the San Jose meeting, but the buzz on the results is positive. Grob and his co-investigators did offer snippets of letters and reactions from study patients. One said, “It feels like healing.” Similar studies of psilocybin in the terminally ill are now launching at New York University in New York City and Johns Hopkins University in Baltimore.
However, the going has been slow, with Doblin carefully dotting every regulatory "i" to prevent a second backlash against psychedelics. "This isn't the '60s," he says. "We've learned the lessons of that era, and now we're trying to integrate ourselves into science, into medicine, into society."
At the San Jose meeting, dubbed "Psychedelic Science in the 21st Century," that integration was in full swing. Eleven hundred therapists, physicians, basic researchers and psychedelics enthusiasts gathered for three days of scientific and cultural talks, visionary art shows and late-night celebrations. The unlikely mix found conservatively dressed researchers from prestigious universities mingling with the heavily tattooed and the green haired.
As for Bledsoe, he's now a true believer. His MDMA sessions were "an almost sacred experience, a very special and uplifting experience," he says. After the therapy, he vacationed in Jamaica, began dating a local woman and bought a house on the island. "I'm happy and well adjusted now," he says. "It's a good fairy-tale ending. As soon as we get some little Bob Marley kids it'll be even better."
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I am sorry to have to question the validity of "science" that uses ecstacy as the "cure" for PTSD, I can still remember when the CIA and the Army wereconducting tests with LSD-25 in the 50s and 60s as the new agent of warfare, the drug that would make everyone forget the horrors of war and hopefully allow the military to have control of the mind of the soldiers under the influence of this drug.
Now here we are another 50 years later and again we have the VA now experimenting with another psychedelic and they are wanting to experiment with others A dozen human studies of MDMA, LSD, a powerful African drug called ibogaine and psilocybin, from so-called "magic mushrooms," are now under way, testing the once-stigmatized drugs
Being one of the 7120 "med vols" I have had a very bad experience with human research and I can not condone anything the government is doing along these lines, the 7120 men of Edgewood Arsenal human experimenst were found in the last medical follow up study to have a 75% death and disability rate in the FY 2000 study published by the IOM as the March 2003 Sarin Report by DR William Page, 3098 men aged 45-65 could not be located using all government databases IRS, VA and Social Security and men aged 45-65are either paying taxes or drawing compensation checks from the VA or Social Security either as SS or SSD the report also reported that of the 4022 men they did find alive 54% of them or another 2200 men were disabled, yet they never explained what the disabilities were, why? Also given that GW1 veterans were exposed to mustard agents and sarin why did the IOM only look at Sarin exposures and NOT mustard agent problems, the Edgewood Arsenal veterans had been exposed to both Sarin and mustard between 1955 thru 1975, the Army destroyed the Iraqi ammo bunkers ay Kamiasyah, Iraq on March 19, 1991 with sarin and mustard filled rockets and artillery shells, spewing the chenical weapons for miles of the spring winds of the desert, if the veterans of the first gulf war may have been exposed to Sarin then it is also likely they were exposed to mustard agents, why hasn't the IOM looked at the medical problems caused by exposure to low level mustard agent exposure or was it the fact that DOD refused to write of fund a contract for the huge potential financial liability they know the mustard agent expsoure would cause, as the known medical problems related to mustard agents are extensive to the human body and the compensation could runinto the hundreds of billions of dollars to the 500,000 veterans of the first gulf war.
Monday, April 5, 2010
Veterans Face Two-Front War: A Response from the DVA
You would have to read the hundreds of emails I get weekly from veterans pleading for help, saying their VSO’s will not return their phone calls. The DAV, as I understand it have reduced their attorney staff that takes cases to the Court of veteran Appeals. Had a veteran who DAV refused to pursue their case to the Court, found him an attorney, won a procedural decision from the court, and is now back at the VBA awaiting a decision. Attorney Bob Walsh is a Godsend to veterans, as is Attorney Joe Moore, and several others. They provide much pro bono help, where no help existed before… what do you do? who do you turn to? after VSO has had your claim for years, then drops you?
Far too many veterans just give up… don’t give up.. at the end of your rope? Get an attorney.
Remember? , 16,112 of the Vietnam Veterans with claims for Parkinson’s are deceased, who should have won their case years ago, if the VSO’s had fought for it, as
Hard as a number of veteran advocates, like me, fought for it. That doesn’t include the many thousands who never filed a claim because a VSO said not to, as it wasn’t covered.
There are a lot of good Vet service officer, but far too many bad ones, and most are overwhelmed just passing the papers back & forth between denial, appeal, denial, appeal and requesting a burial flag, before case is ever decided.
Mike:
I had not seen the article. Thanks for sending it to me.
I was informed recently that the local DAV service officer stood up in a public veterans meeting here in Battle Creek, Michigan and lied to all present.
He said that if you hire an attorney to work on your VA benefits claim and win you will pay 1/3 of the back pay and then 1/3 of the benefits for life.
I charge 20% of the back pay. I do not get paid when I help veterans with new claims. I had over $ 250,000.00 recovered for veterans last year that was pro bono, without fees. Some attorneys charge 33% of the back pay. No attorney can charge a veteran for life.
That lie I suggest is the official “big lie” coming from DAV. I do not think our local service officer could come up with such foolishness on his own.
The DAV response may be accurately stating how much their claimants recovered last year. As to how many cases the DAV takes up to the U.S. Court of Appeals for Veterans Claims (CAVC) and the U.S. Court of Appeals for the Federal Circuit, the answer is very few. To my knowledge no service organization staffed up with attorneys to assist their members after the creation of the U.S. Court of Appeals for Veterans Claims. There is no “G.M. Legal Services Plan” type of free legal assistance available to the membership of the national service organizations. There are only two or three thousand attorneys in the U.S. that assist veterans with benefits claims. The VA has a large number of expert attorneys in Washington to represent them on each case at the CAVC and Federal Circuit.
A few Pro Bono attorneys will not clean up the 1 million claims backlog the VA has created with the able assistance of the DAV and the other service organizations. The system is broken, and veterans and their families suffer every day because of it.
The DAV approach of “pissing on a forest fire” has not been effective for the past 60 years. It is not effective now, and will not work in the future. But they press on.
If you are not part of the solution, then you are part of the problem.
The major changes in veterans benefits in the past 50 years have been through grass roots efforts or by small organizations. Agent Orange was tackled by the Vietnam Veterans of America. A workable G. I. Bill was recently rammed through by the Iraq Afghanistan Veterans Association. The ban on concurrent receipt was a grass roots effort by thousands of disabled military retirees with little support from the large organizations. Veterans for Common Sense had the courage to sue the U.S. Department of Veterans Affairs over the benefits claims processing debacle.
The recent improvements in Agent Orange benefits and Gulf War Illness was the work of a handful of men and women. Less than a hundred. Many of them are seriously ill with the diseases they have been seeking benefits for. They were able to effectuate change in the system. But for 60 years the national service organizations have been unwilling or unable to modernize and improve the system.
I do not believe in bringing a pen knife to a gun fight. I do not think veterans should have to hire an attorney to get their benefits. But since they have had little or no help from the National Service Organizations my position is that 80% of 100% is far better than 100% of nothing, and easier to spend.
These are my personal views and are not the views of the University of Detroit Mercy School of Law or Project Salute.
Veterans Face Two-Front War: A Response from the DVA
Veterans Face Two-Front War: A Response from the DVA
April 3, 2010 by Michael Leon · 39 Comments
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Bob Walsh, Attorney Fighting for Veterans
Last month, Veterans Today ran a piece on the effort of veterans service organizations impeding veterans from getting legal assistance against the U.S. Dept of Veterans Affairs, an agency ranging from hostile to indifferent to the plight of veterans in a rigged and crooked bureaucratic system.
The fact is there is no unified veterans lobby fighting on behalf of veterans to mitigate a hostile bureaucracy.
Veterans service organizations have been captured by the VA and partisan interests. Groups like Veterans for Common Sense and attorneys like Robert Walsh wage a lonely war on behalf of their clients against the VA, but also against the national veteran service organizations that are part of the problem.
Emblematic is the Disabled American Veterans (DAV) that I say seeks an effective roll-back of legal assistance for veterans after years of working against the right of veterans to obtain legal counsel to fight the VA.
Joseph A. Violante, National Legislative Director of the Disabled American Veterans disagrees with the above sentiment. Mr. Violante’s views on the matter are reprinted below, and I will let them stand without further comment so that the group’s view are heard here. Intelligent disagreement is critical, as is dialogue with the enemy.
By Joseph A. Violante
The column, ‘Attorneys Fight for Veterans Against VA and VSOs’ contains some inaccuracies, which I would like to address.
You claim that the Disabled American Veterans (DAV) is targeting the use of attorneys by veterans. This is absolutely false. While we have a resolution calling for repeal of the law that allows attorneys to charge veterans a fee for services render on claims, DAV is not actively pursuing that goal. DAV does not oppose attorneys assisting veterans with their claims; we are opposed to veterans paying forthose services with their earned disability compensation. It is our firm belief that veterans have already paid for their earned benefits. For your information, DAV has reached out to and been contacted by many law firms and individual attorneys who are helping active duty service members and veterans with claims assistance on a pro bono basis. DAV works closely with these attorneys in identifying active duty service members and veterans who need assistance before Physical Evaluation Boards (PEBs) and the U.S. Courts of Appeal for Veterans’ Claims and Federal Circuit.
The reference to Veterans Service Organizations (VSOs) as the ‘veritable enemy’ couldn’t be further from the truth. Last year alone, DAV National Service Officers were responsible for our clients receiving $4.3 billion in new and retroactive benefits. DAV Transition Service Officers are on military installations providing free TAP and DTAP counseling, as well as assisting with claims work and reviewing files. Our Mobile Service Offices, with state-of-the-art electronic equipment, go out to inner cities and rural areas to provide claims representation to veterans who cannot get to regional offices in person. DAV assists any veteran, his or her dependents and survivors free of charge. Our assistance doesn’t stop there. DAV volunteers help veterans in the hospital, drive veterans to and from their VA medical appointments and assist veterans in their communities with services that include cutting lawns or grocery shopping to name but two. These statistics are hardly the work of an enemy.
Again, the reference to VSOs, and specifically DAV, as ‘part of the problem in denying and delaying veterans [sic] disability claims’ is false. You provide no facts to back up this fallacious allegation. First, I believe the benefits we obtain annually for our clients prove you are mistaken. Second, there is no reason for us to delay a veteran’s benefit claim. Unlike an attorney, our representatives get no fee based on the retroactive payment our client receives. Further, we don’t have the ability or any reason to ‘deny’ our own client’s claim. Finally, DAV and many VSOs and Military Service Organizations have been recently working on a comprehensive plan to improve the VA claims process and speed up decisions, outlined in our National Commander’s recent testimony and other testimony provided over the past two years by national legislative staff.
It is interesting that the link embedded in your article, ‘the Attorneys for Veterans right [sic],’ links to a blog that claims it is ‘independent,’ yet it is littered with ads from attorneys looking for business. The page you link to is from 2007, three years ago.
To support the allegations in the article, ‘Attorneys Fight for Veterans Against VA & VSOs,’ you print a letter from a Mr. Priessman. He starts by claiming: ‘Recently, the DAV, after testimony by its Commander, Roberto Barrera, sought to overturn legislation [Public Law 109-461].’ I have no idea where he got that information, because it is totally unfounded. I would direct your readers and Mr. Priessman to National Commander Barrera’s full written statement (http://www.dav.org/voters/documents/statements/Barrera20100302.pdf), DAV Talking Points (issues provided to our members to raise at their meetings with elected officials) (http://www.dav.org/news/NewsArticle.aspx?ID=219) or a video of Commander Barrera’s oral remarks and answers to questions (http://www.youtube.com/watch?v=FzLBDFVNhvU (part 1) and http://www.youtube.com/watch?v=ehZkEhQikNo(part 2)). Nowhere is there any reference to repealing P.L. 109-461, which allows attorney to charge veterans for services. Nowhere is there any mention of attorneys except for DAV’s work with law firms, which provide pro bono services before PEBs and the federal courts. Nor is it clear where he believes we have portrayed ‘attorneys as complete scoundrels’ and ‘veterans as complete dolts.’ DAV employs several attorneys, myself included. DAV’s objection is about attorneys receiving a veteran’s disability compensation as their fee.
There are some veterans or other claimants who believe that they will get better results by using an attorney, but this is simply not borne out by the facts. One need only look at the annual statistics from the Board of Veterans’ Appeals. Annually, attorneys are below the average for allowances. Last year, the average for allowances at the Board was 24 percent. The average allowance rate for attorneys was 22.7 percent. The only group lower than attorneys were unrepresented veterans. Not only did all VSOs come in higher than attorneys, but so did ‘agents’ and ‘other representatives.’ While attorneys do have a higher remand rate and hence a lower denial rate than the averages, there is no way to identify what percent of the remanded cases were for procedural due process reasons and failed to put any money in the veteran’s pocket.
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The only comment on this I have is the DAV VSO had their Power of Attorney revoked by me when their VSO insisted I drop my cardiac claims from Dec 2002 in May 2007 and start a new claim for hypertension a 10% disability which would have cost me the effective date and thousands of dollars in back pay for the CAD and hypertension I was successfully rated for after the BVA appeal which was handled by a pro bono lawyer from NOVA I would have been happy to pay the lawyer the attorney fees they should have been entitled to as the VA does NOW allow the lawyers to collect 20% of back pay on granted claims, since the case was taken pro bono the lawyer declined my offer to pay, "ethics" ruled the day. Something the DAV has forgotten about over the years.......I am now SMC S thanks to a lawyer not the DAV
Friday, February 26, 2010
AKAKA AND SHINSEKI AGREE ON NEED TO REFORM VA CLAIMS SYSTEM
Committee reviews VA budget for coming year
WASHINGTON, D.C. – At a hearing today on the VA budget, U.S. Senator Daniel K. Akaka (D-Hawaii) and Veterans Affairs Secretary Eric K. Shinseki agreed that reforming the VA disability claims system must be a top priority.
“I am encouraged by the Administration’s commitment to add thousands of staff to process veterans’ disability claims, but we should be candid: it appears that the situation will get worse before it gets better,” said Akaka. “It will take years and significant resources to fully train new VA claims staff on the complex existing procedures. We need to bring systemic change to the current process if VA is to provide veterans with the timeliness and accuracy they deserve.”
The President’s budget proposes $125 billion for VA in the coming fiscal year. This is an increase of nearly $11 billion from the previous year, including a $4 billion increase in VA’s medical care account. The President’s budget would also provide funds to increase the number of Veterans Benefits Administration staff by more than 4,000 above last year’s level (including staff added due to the Recovery Act).
Following today’s hearing, Members of the Veterans’ Affairs Committee will provide the Senate Budget Committee with their views and estimates for VA’s budget. Views and estimates are a formal part of the federal budget process, in which Congressional committees recommend funding levels for programs and activities under their legislative jurisdiction. (For the Veterans’ Affairs Committee’s jurisdiction, click here.) The House and Senate Budget Committees review these recommendations when formulating the proposed Budget Resolution for the coming fiscal year.
The Chairman’s opening statement is available here. For the full witness list and the witnesses’ written testimony, please visit http://veterans.senate.gov.
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We veterans have been hearing this for years, just like the VDBC and it's recommendations, it all sounds great when they say it, but then it gets shoved to the back of the shelf and nothing happens.
Start mixing the "pudding" as Bill Cosby used to say the "proof is in the pudding" don't tell us how great it is going to be, just do it.
