DISAMBIGUATION NOTICE: This is the webpage for Veterans for Common Sense (VCS), a non-profit national veterans organization based in Washington, DC – not to be confused with the, “Veterans Coalition for Common Sense,” or, “Florida Veterans for Common Sense,” or the, “Florida Veterans for Common Sense Fund,” which are distinct groups unrelated to VCS.  Read more about us (VCS) here.  

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Veterans for Common Sense provides Testimony to Congress for Hearings on Pending Legislation

Veterans for Common Sense provided the written testimony, below, to the House Committee on Veterans’ Affairs for a May 5, 2021 hearing on pending toxic exposures-related legislation.

Veterans for Common Sense also provided another statement for the record upon invitation of the Senate Committee on Veterans’ Affairs for a similar hearing held on April 28, 2021.


[download PDF]

Statement for the Record of  Veterans for Common Sense
 by Anthony HardieNational Chair and Director
for the House Committee on Veterans’ Affairs
for a Hearing on Pending Legislation
May 5, 2021

Thank you, Chairman Takano and Ranking Member Bost for this hearing regarding pending legislation. We are grateful for this opportunity to provide written testimony for the record.

Veterans for Common Sense is national veterans’ organization focused on education and advocacy on behalf of veterans, military service members, and historically has helped to elevate veterans’ voices in national policy discussions.  Our national board of directors includes most of the leaders of the national Gulf War veterans organization formed in 1995.  Our efforts resulted in the creation of critical Gulf War legislation and related measures, including the seminal Persian Gulf War Veterans Act of 1998 and the Gulf War provisions of the Veterans Programs Enhancement Act of that same year.  Collectively, we helped to implement many of its provisions, to write the initial charter for the first toxic exposure VA advisory committee (the RAC-GWVI, see below for more information), to serve on that committee, to create and serve on and chair the treatment-focused Gulf War Illness Research Program steering committee (Programmatic Panel), to provide testimony integral to countless Gulf War-related Congressional hearings, and so much more.

We appreciate the opportunity to share our views, for this hearing in particular, from the perspectives of Gulf War veteran advocates and veterans affected by Gulf War toxic exposures and the resultant Gulf War Illness.  We hope that our testimony today can help illuminate lessons learned from the experiences of this often-overlooked cohort.  We include eight (8) such “lesson learned”.  We then provide commentary regarding the various bills being considered by the Committee.

In 1996, we developed a five-point plan at our first national conference of our coalescent national coalition of grassroots groups of ill Gulf War veterans and their loved ones.  Our step-by-step plan included the following:

1) INVESTIGATION: an investigation into what happened to us Gulf War troops including to what we may have been exposed;

2) RESEARCH:  medical research to determine the health outcomes associated with each exposure;

3) TREATMENT:  effective treatment for the health outcomes associated with each exposure (later to be described as “evidence-based” treatment);

4) CLAIMS:  an appropriate VA claims process to ensure that VA provided compensation for Gulf War-incurred disabilities that were long-term or permanent;

5) NEVER AGAIN:  a pledge based on that of the Vietnam Veteran veterans who came before us – that never again should what happened to us be allowed to happen again.

In short, our plan was fairly simple to articulate:  Investigation, Research, Treatment, Compensation, and Never Again.  That plan was to serve as an early framework for our 1998 legislation.  The 1998 legislation is described below, drawn from testimony we provided in 2016:[1]

1998 PERSIAN GULF WAR VETERANS LEGISLATION

As I noted in my testimony of February 23 [2016], it took almost eight years after the war before Gulf War veteran’ major legislative victory, with the enactment of the Persian Gulf War Veterans Act of 1998 (Title XVI, PL 105-277) and the Veterans Programs Enhancement Act of 1998 (PL 105-368, Title I—“Provisions Relating to Veterans of Persian Gulf War and Future Conflicts”) – two landmark bills that set the framework for Gulf War veterans’ healthcare, research, and disability benefits.

For those of us involved in fighting for the creation and enactment of these laws, they seemed clear and straightforward, with a comprehensive, statutorily-mandated plan that would guarantee research, treatments, appropriate benefits, and help ensure that lessons learned from our experiences would result in never again allowing what happened to us to happen to future generations of warriors.

The legislation included a long list of known Gulf War exposures.  VA was to presume our exposure to all of these, and then, with the assistance of the National Academy of Sciences (NAS), evaluate each exposure for associated adverse health outcomes in humans and animals.  In turn, the VA Secretary would consider the reports by the NAS’s Institute of Medicine (IOM), “and all other sound medical and scientific information and analyses available,” and make determinations granting presumptive conditions.  There was a new guarantee of VA health care. There would also be a new national center for the study of war-related illnesses and post-deployment health issues, which would conduct and promote research regarding their etiologies, diagnosis, treatment, and prevention and promote the development of appropriate health policies, including monitoring, medical recordkeeping, risk communication, and use of new technologies. There was to be an effective methodology for treatment development and evaluation, a medical education curriculum, and outreach to Gulf War veterans.  Research findings were to be thoroughly publicized.  To ensure the federal government’s proposed research studies, plans, and strategies stayed focused and on track, VA was to appoint a research advisory committee that included Gulf War veterans – presumably those who were ill and affected – and their representatives.

Instead, we learned that enactment of those laws was just another battle in our long war.

From the beginning, VA officials fought against implementing these laws, dragging their feet and upending their implementation.

In addition to the failures I noted in my February 23 [2016] testimony, the process for determining presumptions has failed to yield new presumptions without Congressional intervention.  And, the laws aimed at providing at clear path for Gulf War veterans’ compensation by VA while awaiting the development of effective treatments has been not just problematic, but with extraordinarily high denial rates, as VA’s own data shows and as will be discussed below.

For Gulf War veterans, getting VA to approve a disability claim for a presumptive condition has been nearly impossible for most.  And, as with all denied VA claims, the backlog of appealed claims is daunting and adds years to the process.

That leads now to a discussion of components drawn from Gulf War veterans’ experience and the lessons that can be learned for advancing new legislation related to toxic exposures:

A.  Access to care.   Prior to our 1998 legislation, the ability of veterans was very limited for accessing VA healthcare unless they had an already-approved claim for VA compensation or pension.  Of course, medical evidence was required to win a compensation claim, but without access to healthcare, it was difficult to impossible to receive needed healthcare.

The 1998 legislation provided for two years of VA healthcare for combat veterans.  Later legislation expanded that period to five years.  Of great importance, the TEAM Act would significantly expand that care for veterans with toxic exposures.

LESSON LEARNED1) Granting VA healthcare access to veterans with toxic exposures is critical. 

 

Treatment-focused Research.  However, related to accessing healthcare and as I testified before a House Veterans’ Affairs Subcommittee on Health hearing in 2007, while it was certainly possible “for Gulf War veterans to be seen at VA medical facilities, however, being seen is not the same as being treated.”[2] [emphasis added]

For many Gulf War veterans suffering the adverse health effects of Gulf War toxic exposures, science and medicine did not yet have answers for why they were sick or how to treat their illness.  This remains the case not only for far too many Gulf War veterans, but also for many veterans with burn pits and other toxic exposures.

Even worse, health risk communications publicized by the Department of Defense (DoD) and VA consistently minimized the association between Gulf War service and the adverse health outcomes so many of us were experiencing.  Similar minimization continues even through to the present: alleging no clear links have been found associating deployment or exposures or deployment with adverse health outcomes, “more research is needed,” legislation seeking to resolve these issues is “premature”.  This persistent denial messaging only serves to anger the already injured veteran population.

While the story is too long to tell in this statement, eventually Gulf War veterans benefitted from the creation of the Gulf War Illness Research Program (GWIRP), one of the Congressionally Directed Medical Research Programs (CDMRP) created and funded by Congress through annual Department of Defense Health Agency appropriations.  For reasons that have been provided in detail in past House Veterans’ Affairs Committee hearings, it was and remains of critical importance that this program remains outside of VA.  A Burn Pits Exposure topic area within the Peer Reviewed Medical Research CDMRP (PRMRP) and other disease- and exposure-specific research programs and approved topic areas remain of equally critical importance.  We are deeply grateful to Congress for continuing to support these critically important medical research prograRep.

Also of critical importance is streamlining the process to speed successful research treatments and diagnostic findings to clinicians treating the patients who are affected.  As effective treatments for Gulf War Illness and other toxic exposures and conditions are found, processes to add evidence-based treatments to VA’s formulary and clinical practice must be enhanced.

LESSON LEARNED:  2) Funding treatment-focused medical research aimed at improving health and lives – and bench-to-bedside translational efforts to speed research successes to clinical care – is critically important to ensure veterans being “seen” by VA clinicians are provided with evidence-based healthcare that in fact improves their health and lives.

 

B. Framework for determining new presumptive conditions.

The 1998 Gulf War legislation provided a framework for determining presumptive conditions for VA compensation claims.  That framework should have provided a clear path for additional deployment- or exposure-associated conditions to be determined by the VA Secretary, based on reports from the NAS, as “presumptive”.

Through this framework, the National Academy of Sciences, Engineering, and Medicine (NASEM) has released numerous literature reviews of Gulf War research.  Most of these reports include conclusions regarding the strength of association between deployment to the Gulf War or Gulf War exposures and particular health outcomes.

The five categories are:

  • Sufficient evidence of a causal relationship, that is, the evidence is sufficient to conclude that between being deployed to the Gulf War causes a health outcome.
  • Sufficient evidence of an association; that is, a positive association has been observed between deployment to the Gulf War and a health outcome in humans.
  • Limited/suggestive evidence of an association; that is, some evidence of an association between deployment to the Gulf War and a health outcome in humans exists.
  • Inadequate/insufficient evidence to determine whether an association exists; that is, available studies are of insufficient quality, validity, consistency or statistical power to permit a conclusion regarding the presence or absence of an association.
  • Limited/suggestive evidence of no association; that is, several adequate studies are consistent in not showing an association between deployment and a health outcome.

For Gulf War veterans, the bar for determining these conditions as “presumptive” has been too high and few conditions have met this bar.

Veterans for Common Sense has compiled a complete list[3] of all conditions considered by NAS in the Gulf War and Health series, comprising over 400 exposures, along with their NAS categories of association.  Nearly all fall in the lower three tiers of NAS strength of association determinations.

LESSON LEARNED: 3) A presumptive condition determination framework should set the bar at the “Limited/suggestive evidence of an association” level.

C.  List of exposures. The Persian Gulf War Veterans Act of 1998 provided a list of 32 potential exposures for Gulf War veterans.

(A) The following organophosphorous pesticides: (i) Chlorpyrifos.  (ii) Diazinon.  (iii) Dichlorvos.  (iv) Malathion.  (B) The following carbamate pesticides: (i) Proxpur.  (ii) Carbaryl.  (iii) Methomyl.  (C) The carbamate pyridostigmine bromide used as nerve agent prophylaxis.  (D) The following chlorinated hydrocarbons and other pesticides and repellents: (i) Lindane.  (ii) Pyrethrins.  (iii) Permethrins.  (iv) Rodenticides (bait).  (v) Repellent (DEET).  (E) The following low-level nerve agents and precursor compounds at exposure levels below those which produce immediately apparent incapacitating symptoms: (i) Sarin.  (ii) Tabun.  (F) The following synthetic chemical compounds: (i) Mustard agents at levels below those which cause immediate blistering.  (ii) Volatile organic compounds.  (iii) Hydrazine.  (iv) Red fuming nitric acid.  (v) Solvents.  (vi) Uranium.  (G) The following ionizing radiation: (i) Depleted uranium.  (ii) Microwave radiation.  (iii) Radio frequency radiation.  (H) The following environmental particulates and pollutants: (i) Hydrogen sulfide.  (ii) Oil fire byproducts.  (iii) Diesel heater fumes.  (iv) Sand micro-particles.  (I) Diseases endemic to the region (including the following): (i) Leishmaniasis.  (ii) Sandfly fever.  (iii) Pathogenic escherichia coli.  (iv) Shigellosis.[4] 

D. Concession of exposures. As directed by the law, VA contracted with the NAS for reviews of these exposures (and not limited to these exposures) and whether Gulf War veterans “may have been exposed.” In report after report in the NAS’s “Gulf War and Health” series, the NAS was unable to determine actual levels of exposure for Gulf War troops, including dose-response relationships, due in large part to flawed, inadequate, and incomplete troop location data, lost troop medical and other records, inadequate environmental sampling data, and so on.

Unfortunately for Gulf War veterans, the list of 32 exposures in the enacted legislation and resulting law[5] did not rise to the level of an actual concession of exposures.  Instead, the enacted legislation used indeterminate language: “may have been exposed”; “may have been exposed for purposes of any report under subsection…”.

The end result of the Gulf War framework has been deeply disappointing to Gulf War veterans:  no concessions of exposure to any of the toxic and hazardous exposures identified by Congress in law (with the exception of nine rare endemic infectious diseases, which have been of little consequence for most veterans deployed to the theatre of operations) and essentially no new presumptive conditions resulting from that framework.

Thus, Gulf War veterans have never received the same benefit of a concession of exposures granted to Agent Orange veterans, and as would be granted — to a more limited extent – by pending toxic exposures legislation.  That task probably falls to Congress to determine.  To date, Gulf War veteran reliance on DoD and VA to concede exposures has not succeeded despite a carefully articulated and well-intentioned framework enacted in the 1998 legislation.

LESSONS LEARNED:  4) Conceding exposures is critical, and that task probably falls to Congress to legislate.

 

E. Plausibility of etiology. An important method for determining the plausibility of adverse health outcomes has been the use of experimental models of exposures.  These models have primarily involved the use of experimental rats and mice, though others have used cockroaches, cell lines, and machine learning.

We have provided extensive prior testimony on this critical aspect of any NAS or similar studies to determine the association between exposures (or deployment) and health outcomes.

See:  “Statement for the Record of James Binns, Roberta White, Anthony Hardie, & Paul Sullivan for a September 23, 2020 Hearing of the Committee on Veterans’ Affairs, Subcommittee on Disability Assistance and Memorial Affairs, Entitled: “Toxic Exposures: Examining Airborne Hazards In The Southwest Asia Theater Of Military Operations”.

LESSON LEARNED:  5) Animal studies of toxic exposure are critical to understanding plausible health outcomes associated with toxic exposures.

 

F.  List of Presumptive Conditions.

Gulf War legislation enacted in 1994 provided for presumptive “undiagnosed illness” (UDX) claims.  However, VA’s high rates of denial of these claims led to Congress’ 1998 Gulf War legislation to develop an elegant, science-based, framework for specifying new presumptive conditions for Gulf War veterans.   Unfortunately, VA’s persistent high rates of denial of these presumptive UDX claims led to legislation enacted in 2001 making “medically unexplained chronic multisymptom illnesses” (MUCMIs) presumptive.

Tragically for Gulf War veterans, VA’s high rates of denial of Gulf War veterans’ presumptive claims for “undiagnosed illness” (UDX) and “medically unexplained chronic multisymptom illnesses” (MUCMIs) persist to the present time – along with similarly high rates of denial of Burn Pits Exposure-related claims.

By contrast, Vietnam veterans with presumed exposure to Agent Orange have fared better, with a long list of presumptive conditions now approved.  It is noteworthy that many of these named presumptive conditions required legislation. Indeed, one of the bills now before the Committee would name additional Agent Orange presumptive conditions that VA has failed to make presumptive despite strong evidence and favorable NAS review.

While a framework for Vietnam veterans that presumes exposure to Agent Orange has led to some favorable determinations for new presumptive conditions, Congress has been required to legislate other named presumptive conditions.

 LESSON LEARNED:  6) Named presumptive conditions are critical for toxic exposure veterans.  7) A science-based presumptive determination framework is of significant value. 8) Congress is likely still going to be called upon to act when the science is clear regarding associations of health outcomes with exposures when VA fails to take appropriate action on its own.

 


PENDING LEGISLATION:


H.R. 1273 – Vietnam Veterans Liver Fluke Cancer Study Act:

 Veterans for Common Sense is broadly supportive of efforts to identify health conditions that may be of greater prevalence or incidence among particular veteran cohorts.  This legislation is regarding the rates of cholangiocarcinoma, cancer that forms in the bile ducts that connect the liver and gallbladder to the small intestines.  According to the Cholangiocarcinoma Foundation, among the risk factors are exposure to dioxin found in Agent Orange or to parasitic liver fluke infections most commonly seen in some Asian countries.[6]

Section 2 of the bill is titled, “Study on the Prevalence of Cholangiocarcinoma in Veterans who Served in the Vietnam Theater of Operations During the Vietnam Era”.  This legislation defines “covered veterans of the Vietnam Era” as “veterans who served in the Vietnam theater of operations during the Vietnam era” – in other words, Vietnam War veterans, who were most at risk for exposure to liver flukes and/or dioxin.  This legislation seeks to determine the incidence and prevalence of this condition only in these Vietnam War veterans (where parasitic liver fluke infection and/or dioxin exposures are most likely to have occurred) via an epidemiological study conducted by the VA in consultation with the U.S. Centers for Disease Control and Prevention (CDC).  The bill directs data from “residents of the United States” to be used as a comparison.  However, it may be of added value to include an additional comparison group: Vietnam Era veterans without Vietnam War service.

Section 2 of the bill also directs a Report to Congress containing the results of the study and recommendations for administrative or legislative actions required to address issues identified in the study.  The bill directs this report to be provided to Congress, “not later than one year after the completion of the study”.  Given the poor prognosis and short lifespan of many cholangiocarcinoma patients following diagnosis, it would seem to be of significant value to these veterans to legislatively impose expedited benchmarks and an expedited deadline for reporting the completed study’s findings to Congress.

Finally, we would like to remind the Members of the Committee of a 2013 subcommittee hearing[7] that featured Dr. Steven Coughlin, who had just resigned his position as senior epidemiologist in the VA Office of Public Health (OPH) “because of serious ethical concerns”, about which he provided compelling testimony.[8]  VA-OPH has since been renamed the Office of Post Deployment Health Services (PDHS).  Among Dr. Coughlin’s statements in that testimony:

  • The Office of Public Health conducts large studies of the health of American veterans. However, if the studies produce results that do not support OPH’s unwritten policy, they do not release them.  This applies to data regarding adverse health consequences of environmental exposures…”   [From direct communications with Dr. Coughlin, Veterans for Common Sense understands this OPH (now PDHS) “unwritten policy” to include failing to research conditions that may be of greater incidence or prevalence among cohorts of veterans with toxic exposures, failing to publish such findings if found, minimizing such findings, deflecting physical conditions to appear as psychosomatic, and generally practicing a policy of “don’t look, don’t find.”]
  • Speaking as a senior epidemiologist with almost 30 years of research experience, there is no reason to work night and day for years on a complex data collection effort (which cost US taxpayers millions of dollars) … if no scientific publications are released.
  • My supervisor, Dr. Aaron Schneiderman, told me not to look at data regarding hospitalizations and doctors’ visits.”
  • Another example of important data that has never been released are the results of the Gulf War family registry mandated by Congress. These were physical examinations provided at no charge to Gulf War veterans’ family members.  I have been advised that these results have been permanently lost.”
  • The Office of Public Health has also manipulated information regarding veterans’ health through the questions included in their surveys.”
  • The VA Chief of Staff (COS) directed my supervisors to send the Gulf War study scientific protocol and draft questionnaire out for additional, objective scientific peer review.… The Chief of Staff was never informed that the outside reviewer worked for a friend of Dr. Peterson” [the OPH Chief Science Officer].
  • My supervisors also made false statements in writing to the Chief of Staff.” “…as a result, the Chief of Staff ordered the survey to proceed without the changes.
  • Last year, VA contracted with the IOM for a Congressionally-mandated study of treatments for chronic multisymptom illness in Gulf War veterans. Many Gulf War veterans were distressed that five speakers selected to brief the IOM committee presented the view that the illness may be psychiatric, although science long ago discredited that position.  My understanding is that Dr. [Michael] Peterson, an OPH Chief Science Officer, identified the speakers the IOM should invite.”
  • I also urge you to initiate legislation to cure the epidemic of serious ethical problems in the Office of Public Health I have described to you today. In view of the pervasive pattern where these officials fail to tell the truth, even to VA leadership, VA cannot be expected to reform itself.  These problems impact the balance of risks and benefits of federally funded human subjects research costing tens of millions of dollars and which fail to serve the interests of the veterans they are intended to benefit.”

It is unclear whether the necessary personnel and policy changes have been made within this VA office to correct the longstanding, egregious, “don’t look, don’t find” issues exposed to the light of day through Dr. Coughlin’s courageous resignation and public testimony.[9]  Given this bill’s directive for VA to conduct an epidemiological study, it would seem prudent to ensure “the epidemic of serious ethical problems in the Office of Public Health” identified by Dr. Coughlin in public testimony before members of this Committee have been fully resolved before proceeding. 

Veterans for Common Sense supports H.R. 1273, the Vietnam Veterans Liver Fluke Cancer Study Act, and is grateful to Rep. Slotkin, Rep. Garbarino, Rep. Suozzi, Rep. Fitzpatrick, Rep. Posey, and Rep. Neguse for introducing this legislation.

Veterans for Common Sense commends Vietnam Veterans of America and the DAV for their leadership in helping to make clear the urgent need for this study and advocating in support of this legislation.

 

H.R. 1355 (S. 454) — K2 Veterans Care Act of 2021:

 Veterans for Common Sense supports this legislation conceding exposure to certain hazards and toxic exposures for covered veterans.  However, we express concern that some of these, like Depleted Uranium, have previously been the subject of NAS reviews without favorable consideration and “more study is needed”-type recommendations.

Veterans for Common Sense thanks Rep. Lynch, Rep. Green of Tennessee, Rep. Ryan, Rep. Fitzpatrick, Rep. San Nicolas, Rep. Welch, Rep. Speier, Rep. Grijalva, Rep. Williams of Texas, Rep. Kelly of Mississippi, Rep. Cooper, Rep. Crenshaw, Rep. Johnson of Georgia, Rep.  Omar, Rep. Norton, Rep. Radewagen, Rep. Webster of Florida, Rep. Bustos, Rep. Steube, Rep. Grothman, Rep.  Rodgers of Washington, Rep. Chabot, Rep. Tiffany, Rep. Stewart, Rep. Craig, Rep. Phillips, Rep. Foxx, Rep. Posey, Rep. Keating, Rep. Budd, Rep.  Bice of Oklahoma, Rep.  Titus, Rep.  Malliotakis, Rep. Gaetz, Rep. Katko, Rep. Massie, Rep. Gohmert, Rep. Norman, Rep. Babin, Rep. Bacon, Rep. Van Drew, Rep. Baird, Rep. Moore of Alabama, Rep. Trahan, Rep. Gosar, Rep. Murphy of North Carolina, Rep. González-Colón, Rep. Payne, Rep. Boebert, Rep. Kim of California, Rep. Moulton, Rep. Pappas, Rep. Foster, Rep. Johnson of South Dakota, Rep. Cawthorn, Rep. Stauber, Rep. Bilirakis, Rep. Meijer, Rep. McKinley, Rep. Graves of Missouri, and Rep. Young for introducing this legislation in the House, and to Senator Blumenthal, Senator Baldwin, Senator Brown, Senator Menendez, and Senator Feinstein for their introduction of this legislation in the Senate.

 

H.R. 1585 (S. 565) — Mark Takai Atomic Veterans Healthcare Parity Act of 2021:

Veterans for Common Sense supports efforts to provide full eligibility for VA healthcare eligibility and service-connected disability compensation benefits to all Atomic Veterans.

Veterans for Common Sense also supports efforts, including by the National Association of Atomic Veterans (NAAV), to authorize, create, and award, including posthumously, an Atomic Veteran Service Medal to all Atomic Veterans.

According to the NAAV, Atomic Veterans include all of the following:

“Atomic Veterans were members of the United States Armed Forces who participated in atmospheric and underwater nuclear weapons tests from 16 July 1945 to 30 October 1962.  They also include veterans who were assigned to post test duties, such as “ground zero” nuclear warfare maneuvers & exercises, removing radiation cloud samples from aircraft wing pods, working in close proximity to radiated test animals, de-contamination of aircraft and field test equipment, retrieval and transport of test instruments & devices, and a host of other duty assignments that provided an opportunity for a radiation exposure & contamination event.  Also included are military personnel who were a part of the Occupation Forces assigned to Hiroshima and Nagasaki, Japan soon after the detonation of Atomic-Bombs over those respective cities, and those American prisoners of war (POW’s) who were housed in close proximity to those cities.”

“There is a second group of veterans who may have been involved in radiation exposure events. These include post test events related to nuclear weapon devices detonated underground or in shafts (after 1962) that may have provided a radiation exposure event, or those [whose] duties involved regular use of radiation producing equipment or processes, such as power plant technicians aboard nuclear powered Aircraft Carriers and Submarines, X-ray technicians, and those veterans assigned to the Enewetak Atoll radiation clean-up projects.[10]

According to a 2019 Stars and Stripes article:

“We were experimental subjects who did not give our advised consent to be experimental subjects,” said [Atomic Veteran Linclon] Grahlfs, 96, a retired sociology professor and author of the book “Voices From Ground Zero: Recollections and Feelings of Nuclear Test Veterans.”

At least 200,000 U.S. troops participated in the tests and cleanup operations during World War II and later in the Pacific Ocean, the Nevada desert, New Mexico and the Atlantic Ocean. They took the human brunt of deadly ionizing radiation that contaminated nearby lands, water and communities.  Even today, the wide-ranging implications of hundreds of tests conducted from the 1940s until the 1960s and cleanup operations that followed in the late 1970s has yet to be fully understood. In all, the U.S. has conducted more than 900 such tests.

Until 1996, the atomic vets were sworn to silence, forced to keep their burdens from their families, their friends and doctors. They had limited records and medical help for their illnesses, and faced a threat of prison if they revealed the secret too soon.[11]

It is unclear whether all Atomic Veterans who are still living know that the Nuclear Radiation and Secrecy Agreements Act, which bound these veterans to secrecy regarding the operations that exposed them to radiation, was repealed.  S. 565 would expand Atomic Veteran-related benefits to veterans who participated in the “Cleanup of Enewetak Atoll during the period beginning on January 1, 1977, and ending on December 31, 1980”.

In keeping with the goals stated above, Veterans for Common Sense strongly supports S. 565, the Mark Takai Atomic Veterans Healthcare Parity Act of 2021

Veterans for Common Sense is grateful to Rep. Meng, Rep. Beatty, Rep. Lowenthal, Rep. Fitzpatrick, Rep. Titus, Rep. San Nicolas, Rep. Kirkpatrick, Rep. Swalwell, Rep. Kahele, Rep. Moulton, Rep. Welch, Rep. McGovern, Rep. Gallagher, Rep. Speier, Rep. Thompson of California, Rep. Grijalva, Rep. Castor of Florida, Rep. Cohen, Rep. Pappas, Rep. Suozzi, Rep. Takano, Rep. Lee of California, Rep. Pallone, Rep. Smith of Washington, Rep. Kilmer, Rep. Vargas, Rep. DeGette, Rep. DelBene, Rep. Ryan, Rep. Brendan F. Boyle of Pennsylvania, Rep. Connolly, Rep. Pocan, Rep. Norton, Rep. Foster, Rep. McCollum, Rep. Garbarino, Rep. Moore of Wisconsin, Rep. Bonamici, Rep. Deutch, Rep. Torres of California, Rep. Auchincloss, Rep. Brownley, Rep. Panetta, Rep. Lieu, Rep. Pingree, Rep. Carolyn B. Maloney of New York, Rep. Price of North Carolina, Rep. Raskin, Rep. García of Illinois, Rep. Nadler, Rep. Bishop of Georgia, Rep. Burgess, Rep. Stevens, Rep. Velázquez, Rep. Schneider, Rep. Schrader, Rep. Kildee, Rep. Sherrill, Rep. Dingell, Rep. Larsen of Washington, Rep. Demings, Rep. Chu, Rep. Beyer, Rep. Lois Frankel of Florida, Rep. Rutherford, Rep. Perlmutter, Rep. Case, Rep. Lawrence, Rep. DeFazio, Rep. Zeldin, Rep. Axne, Rep. Baird, Rep. Carbajal, Rep. Peters, Rep. Rush, Rep. Cleaver, Rep. Sablan, Rep. Espaillat, Rep. Kuster, Rep. Rice of New York, Rep. Higgins of New York, Rep. Yarmuth, Rep. Quigley, Rep. Schiff, Rep. Evans, Rep. Escobar, Rep. Spanberger, Rep. Bustos, Rep. Courtney, Rep. Sires, Rep. Costa, Rep. Carson, Rep. Blunt Rochester, Rep. Garamendi, Rep. Vicente Gonzalez of Texas, Rep. Aguilar, Rep. Brown, Rep. Hastings, Rep. Lamb, Rep. Phillips, Rep. Luria, Rep. Himes, and Rep. Rodney Davis of Illinois for introducing this legislation in the House. Veterans for Common Sense is to gratefulSenator Smith, Senator Tillis, Senator Leahy, Senator Hirono, Senator Klobuchar, Senator King, Senator Warren, Senator Wyden, Senator Van Hollen, Senator Coons, Senator Merkley, Senator Markey, Senator Sinema, Senator Blumenthal, Senator Collins, and Senator Baldwin for their introduction of this legislation in the Senate.

Veterans for Common Sense commends the tireless and unwavering efforts of the National Association of Atomic Veterans, on behalf of the entire cohort of Atomic Veterans they represent, to achieve justice, healthcare, benefits, and recognition for these long-overlooked veterans.  As our nation works to achieve justice for veterans with toxic exposures, it is of great importance that these Atomic Veterans are finally awarded all the measures of justice that they have long sought.

 

H.R. 1972 (S. 810) – Fair Care for Vietnam Veterans Act of 2021:

The Fair Care for Vietnam Veterans Act would beneficially add two additional conditions to the list of named conditions already approved as “presumptive” for Vietnam War and other veterans presumed to be exposed to Agent Orange.

A 2015 study of the Ranch Hand cohort of Vietnam veterans published in a peer-reviewed Journal of the American Medical Association found a 2.4-fold increased risk for Monoclonal Gammopathy of Undetermined Significance (MGUS) in Ranch Hand veterans versus comparison veterans after adjusting for age, race, and other relevant factors.  The study authors concluded: “Operation Ranch Hand veterans have a significantly increased risk of MGUS, supporting an association between Agent Orange exposure and multiple myeloma.”[12]  According to a press release by the National Academy of Sciences, Engineering, and Medicine (NASEM) for the release of its, “Agent Orange: Update 11 (2018)” report, “MGUS is a clinically silent condition that is a precursor to the cancer multiple myeloma, but only an estimated 1 percent of MGUS cases progress to multiple myeloma each year.”[13]

NASEM’s Update 11 (2018) also upgraded its conclusions regarding the strength of association between exposure to the chemicals of interest and hypertension.  Previously, NASEM had rated hypertension as, “limited/suggestive evidence of an association”, the middle tier of its five-tier rating system for strength of association.  In Update 11 (2018), NASEM upgraded its rating regarding hypertension in Vietnam War veterans to, “sufficient evidence of an association,” the second-highest rating, based on the available published scientific evidence.

This MGUS study was published than half a decade ago and the NASEM report more than two years ago, but VA has yet to take action to make these conditions presumptive for veterans exposed to Agent Orange.  It is notable that Congressional action is once again required to add these presumptive conditions via legislation, conditions which have already been found by science to be of greater prevalence in Vietnam veterans than comparison veterans.

In light of VA’s failure to act on the published scientific evidence regarding the excess prevalence of these conditions among Vietnam War veterans, Veterans for Common Sense strongly supports S. 810, the Fair Care for Vietnam Veterans Act of 2021, to add hypertension and Monoclonal Gammopathy of Undetermined Significance (MGUS) as Agent Orange presumptive conditions.

Veterans for Common Sense is sincerely grateful to Rep. Harder and Rep. Stauber for introducing the Fair Care for Vietnam Veterans Act in the House to add named “presumptive” conditions for VA disability compensation for Vietnam War veterans, and to Senator Tester, Senator Wyden, Senator Brown, Senator Durbin, Senator Cortez Masto, Senator Menendez, Senator Schumer, Senator Casey, Senator Leahy, Senator Manchin, Senator Blumenthal, Senator Coons, Senator Murray, Senator Klobuchar, Senator Hirono, Senator Smith, and Senator Booker for introducing this legislation in the Senate.

Veterans for Common Sense also commends Vietnam Veterans of America for its enduring leadership in ensuring that health conditions identified as greater in prevalence among Vietnam Veterans continue to be added as named presumptive conditions by whatever means necessary for the Vietnam War veterans VVA so powerfully represents.

 

H.R. 2127 (S. 927) – Toxic Exposure in the American Military Act (TEAM) Act:

 Veterans for Common Sense strongly supports the expansion of access to VA healthcare that would be granted under this legislation.

Veterans for Common Sense strongly supports the provision of this legislation that would set the bar for NAS strength of association determinations at the “Limited/suggestive evidence of an association” level.

Veterans for Common Sense cautiously supports this bill’s creation of a framework for determining presumptive conditions but given the experience of Gulf War veterans with a similar enacted framework, we are understandably concerned about whether such a process will in actuality result in new, fair, and timely presumptive conditions consistently being added for veterans with those conditions.

Veterans for Common Sense strongly supports the creation of the advisory and oversight body described in this legislation.  While the Research Advisory Committee for Gulf War Illnesses (RAC) created in Gulf War legislation enacted in 1998 did an excellent job in its mission, ultimately, its scope and membership were slashed by VA.  Legislation to properly restore the RAC, which passed the House with unanimous consent,[14] had a new structure and process for naming members that is somewhat similar to that contained in the TEAM Act.

We express concern that language in the current draft of the legislation would not allow for the appropriate and necessary consideration by the NAS of animal studies modeling toxic exposures and health outcomes in those animals.  That language is as follows:  “…that a positive association exists between the exposure of humans to a toxic substance and the occurrence of a disease in humans…”   Such animal studies can be critical for understanding plausible health outcomes in humans, particularly in cases of toxic or hazardous exposures where there is a paucity of human health outcomes data and it would be unethical to conduct experiments exposing humans to such toxins or hazards for scientific evaluation purposes.

Veterans for Common Sense thanks Chairman Bost, Rep. Nehls, Rep. Miller-Meeks, Rep. Moore of Alabama, Del. Radewagen, Rep. Mann, Rep. Bergman, Rep. Rosendale, Rep. Cawthorn, Rep. Banks, Rep. Bilirakis, and Rep. Smith of New Jersey for leadership in introducing the TEAM Act in the House, and to Senator Tillis, Senator Hassan, Senator Moran, Senator Klobuchar, Senator Blackburn, Senator Baldwin, and Senator Capito for their leadership in introducing this legislation in the Senate.

Veterans for Common Sense commends the TEAM Coalition, led by the Wounded Warrior Project, for its collaborative efforts in developing the legislative proposals contained in the TEAM Act.


H.R. 2268 – Keeping Our Promises Act

Veterans for Common Sense supports H.R. 2268, the Keeping Our Promises Act, which would add additional “named” presumptive conditions for veterans with Agent Orange exposure.

We note that prostate cancer, AL amyloidosis, Early-onset peripheral neuropathy, and ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal’s angina) are already presumptive conditions for veterans with “exposure to certain herbicide agents” under 38 CFR 3.309(e).  By adding stroke and hypertension as named presumptive conditions for these veterans, many veterans would be newly eligible for earned VA benefits and healthcare.

Veterans for Common Sense is grateful to Rep. Westerman, Rep. Thompson of California, Rep. Harshbarger, Rep. Neguse, Rep. Bergman, Rep. Pingree, Rep. Boyle, Rep. Morelle, Rep. Delgado, Rep. Omar, Rep. Cohen, Rep. Bilirakis, Rep. Walorski, Del. Radewagen, Rep. Rutherford, Rep. Griffith, Rep. Kim, Rep. Axne, Rep. Fitzpatrick, and Rep. Porter for their leadership in introducing this legislation in the House.
Veterans for Common Sense commends Vietnam Veterans of America for its enduring leadership in ensuring that health conditions identified as greater in prevalence among Vietnam Veterans continue to be added as named presumptive conditions.

 

H.R. 2368 – Conceding Our Veterans’ Exposure Now and Necessitating Training (COVENANT) Act

Veterans for Common Sense supports H.R. 2368, the COVENANT Act, and is sincerely grateful to Rep. Luria for introducing this important legislation.
Veterans for Common Sense supports the presumption of airborne hazard exposures named in the COVENANT ACT.

Veterans for Common Sense supports the COVENANT Act’s provisions that would add a list of named presumptive conditions for covered veterans with qualifying locations and periods of military service commencing August 1990.  The COVENANT Act favorably replicates two of three lists of named exposures in the War Fighters Act, but unfavorably leaves off the addition of Agent Orange presumptive conditions, which Veterans for Common Sense supports including.  The COVENANT Act favorably adds two additional respiratory conditions not named in the War Fighters Act: rhinitis, and sinusitis – both commonly reported among Gulf War and burn pits exposure veterans, the inclusion of which Veterans for Common Sense strongly supports.

Veterans for Common Sense supports the inclusion of both pre- and post-9/11 veterans in this and other toxic exposure legislation.  However, the COVENANT Act does not yet include coverage for veterans with service in the airspace above or contiguous waters of covered locations (named countries of service).  Learning from past lessons relative to Blue Water Navy veterans for Agent Orange/herbicide presumptive exposure, it is important to include such veterans in the initial legislation.

Veterans for Common Sense supports in concept requirements for mandatory training, reviewed by relevant veterans service organizations, for all VA-employed and -contracted health care and benefits personnel whose work involves veterans with toxic exposures.

Regarding the legislation’s provisions regarding Eligibility for [health] Care, we are concerned that the provision only expands coverage for “diagnosed illness”.  We discuss this in greater detail elsewhere in this statement.

 

H.R. 2436 (S. 437) – Veterans Burn Pits Exposure Recognition Act of 2021:

Veterans for Common Sense supports this legislation conceding exposure to four types of airborne hazards and toxic exposures for covered veterans.

We encourage the Committee, in considering this legislation, to expand the covered veterans in this legislation to be as complete as in other current toxic exposure legislation (including airspace and contiguous waters veterans, so as not to create a new class of Blue Water Navy/Air veterans), such as the Presumptive Benefits For War Fighters Exposed To Burn Pits And Other Toxins Act.

We express concern regarding the inclusion of the “causal” terminology in the bill as currently drafted:  “…the Secretary shall request a medical opinion as to any causal link between the disability and a toxic substance, chemical, or hazard set listed in subsection (c)…” [emphasis added].  We are concerned this may be interpreted by VA as parallel to the NAS causation standard of association, an impossibly high bar to meet.

Veterans for Common Sense is grateful to Representatives Slotkin and Meijer for introducing this legislation in the House, and to Senator Sullivan and Senator Manchin for their introduction of this legislation in the Senate, and to the many House Members and Senators who have cosponsored it.

Veterans for Common Sense is also deeply grateful to the Disabled American Veterans (DAV) for their leadership efforts in seeking to improve disability claims outcomes for veterans with toxic exposures.

 

H.R. 2371 (S. 952) – Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act:

In the strongest possible terms, Veterans for Common Sense supports the list of named presumptive conditions in this legislation, including respiratory conditions, cancers, and the conditions already presumptive for Agent Orange veterans.

Veterans for Common Sense also very strongly supports the comprehensiveness of covered veterans in this legislation, which includes veterans awarded various service medals for their Global War on Terrorism (GWOT service, and extends back to August 1990 and veterans awarded the Southwest Asia Service Medal (SWASM), Armed Forces Expeditionary Medal (AFEM), and other service medals.

As we previously stated publicly, for many veterans with toxic exposures, there has been – for them – a clear timeline connecting their toxic exposures during their military deployments to the debilitating health outcomes that followed them home. Far too many veterans who were exposed to open burn pits and a veritable toxic soup have developed terrible respiratory conditions, Parkinson’s and other diseases, and cancers, including the brain cancer that has taken so many of their lives.  This critically important legislation will provide the missing link to help these veterans.  Indeed, this is the only current, major toxic exposure legislation to actually name presumptive conditions for VA disability claims rather than lay out a bureaucratic process that relies on trusting VA to do the right thing — the same VA that currently denies Gulf War and Burn Pits-related claims at 80 percent denial rates.  In this year of the 30th anniversary of the beginning of the Gulf War (Operation Desert Storm), we are deeply grateful to Senator Gillibrand and the many powerful cosponsors for ensuring this legislation will help so many veterans who served, including Gulf War, other pre-9/11, and post-9/11 veterans alike.

Veterans for Common Sense profoundly thanks Representatives Ruiz and Fitzpatrick for introducing this legislation in the House, and Senators Gillibrand and Rubio for their leadership in introducing this legislation in the Senate.

Veterans for Common Sense wholeheartedly commends Burn Pits 360, Jon Stewart, John Feal, and the many supportive organizations involved for their efforts on this crucial legislation.

 

H.R. 2530 – related to conducting a study on radiation exposure relating to the cleanup of Enewetak Atoll

This legislation would direct VA to enter into an agreement with NASEM to conduct a study on the level of radiation exposure experienced by members of the Armed Forces who participated in the cleanup of Enewetak Atoll between 1977 and 1980.

While clearly well intentioned, the veterans who would benefit from this legislation are aging.

We would prefer to see legislation granting a presumption of radiation exposure to these veterans rather than embarking on years of additional study with no clear path to success for awarding these veterans with disability benefits for health conditions presumed under 38 USC 1112(c) for radiation-exposed veterans and waiving any dose assessments that may be required by VA under 38 CFR 3.311.

With those caveats, Veterans for Common Sense supports H.R. 2530, related to conducting a study on radiation exposure relating to the cleanup of Enewetak Atoll.

Veterans for Common Sense is grateful to Representatives Nehls and Luria for their introduction of this legislation intended to help veterans with likely radiation exposure during their assignments relating to the cleanup of Enewetak Atoll.

H.R. 2569 – Veterans Agent Orange Exposure Equity Act

Veterans for Common Sense supports H.R. 2569, the Veterans Agent Orange Exposure Equity Act, which would expand the presumption of herbicide exposure to veterans whose Vietnam War service was in countries in close proximity to Vietnam, including Thailand, Laos, and Cambodia.

Veterans for Common Sense thanks Rep. Cartwright, Rep. Fitzpatrick, Rep. Morelle, Rep. O’Halleran, Del. Norton, Rep. Titus, Rep. Sires, Rep. Hayes, Rep. Tlaib, Rep. Pascrell, Rep. Lawson, Rep. Carson, and Rep. Kilmer for their introduction of the Veterans Agent Orange Exposure Equity Act.

Veterans for Common Sense commends Vietnam Veterans of America for its work advocating for the provisions of Veterans Agent Orange Exposure Equity Act.

 

H.R. 2580 (S. 1151) – Palomares Veterans Act

As the Palomares Veterans Act notes, in 1966, the collision of a United States Air Force B–52 bomber and refueling plane in the vicinity of Palomares, Spain caused the release of four thermonuclear weapons.  The Palomares Veterans Act would add participation in Palomares recovery activities to the statutory list of “radiation risk activities” listed at 38 USC 1112(c)(3)(B).

Importantly, this legislation would also expand eligibility for DIC benefits regardless of whether the covered death occurred before or after the enactment of this legislation.

Veterans for Common Sense supports H.R. 2580, the Palomares Veterans Act, and commends Rep. Hayes for her introduction of this legislation in the House, and Senator Blumenthal, Senator Warren, and Senator Feinstein for introducing this legislation in the Senate.

We note with potential concern VA’s radiation dose requirements for radiation-exposed veterans under 38 CFR 3.311.  If such dose requirements are not possible to obtain, or if they are insufficient for some or all veterans covered under this important legislation, it may be of importance to add a provision waiving any dose assessments that may be required by VA under 38 CFR 3.311.

 

H.R. 2607 – FASTER Presumptions Act

Veterans for Common Sense commends Rep. Trone for introducing the carefully authored Fairly Assessing Service-related Toxic Exposure Residuals Presumptions Act (“FASTER Presumptions Act”).

Veterans for Common Sense strongly supports the creation of the three advisory bodies under this legislation, and the authority of the Science Review Board or Working Group (Sec. 1174) created under this bill to actually commission research within or outside VA.  Veterans for Common Sense strongly supports the expeditious timeline of determinations that would be made under this legislation.

Veterans for Common Sense strongly supports the creation under this legislation of the Expert Advisory Panel on Constrictive Bronchiolitis (Sec. 1175).  We advise the Committee of in-progress, federally funded medical research efforts to develop methods of diagnosis of constrictive bronchiolitis /obstructive bronchiolitis that do not require an invasive lung biopsy.[15]  Should such research efforts succeed, they may obviate the requirements of this legislation specifying the Advisory Panel’s mandate to, “establish histologic and pathology criteria for confirming diagnoses”.

For the legislation’s provisions regarding Access to Health Care, we are concerned that the provision only expands coverage for “diagnosed illness”.  This hearkens back to much darker days when VA provided healthcare primarily only to veterans granted service-connection or pension, while still requiring sufficient medical evidence in order to grant service-connection – evidence and diagnoses that were difficult or impossible to obtain through VA without already having service-connection.  This was a terrible Catch-22 and led to 1998 legislation discussed elsewhere in this statement that granted two years of VA healthcare for combat veterans, later expanded to five years, and as would be further expanded by the TEAM Act, which is more favorable to toxic exposure veterans in this regard.
Veterans for Common Sense supports in concept the provision of this legislation mandating DoD surveillance and monitoring relative to toxic exposures, mandatory training of covered employees.

Veterans for Common Sense supports in concept the required epidemiological studies in Section 4 of this legislation, but notes advice provided elsewhere in this statement regarding VA conduct of epidemiological studies.

In considering this legislation, which would create interlocking new committees to advise VA on toxic exposure presumptive condition determinations and reviews, it may be of substantial value to recall the experience of another statutory VA advisory committee tasked with making toxic exposure research recommendations, the Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI or simply “RAC”). The essence of that experience is as follows: VA officials did not like the unanimous RAC finding of “no confidence” in VA’s ability to solve Gulf War Illness following VA’s whitewashing of a jointly-approved RAC and National Research Advisory Committee (NRAC) consensus recommendations report, the development of which had included full VA staff participation; VA officials gutted the RAC-GWVI charter, restricting its scope; VA officials removed all the remaining RAC members, replacing them with non-experts in Gulf War Illness, the sole intended focus of the RAC; VA officials removed all the remaining Gulf War Illness-afflicted veterans on the panel, replacing them with primarily Gulf War veterans not afflicted by Gulf War Illness nor having experience nor understanding of Gulf War Illness.

Thereafter, legislation to restore the integrity of the RAC was introduced in the House and passed with unanimous consent, before being bogged down in the Senate and failing to pass prior to the end of the Congress.  That legislation was similar to the current TEAM Act in important ways with regards to the appointment of its membership.  Veterans for Common Sense strongly urges the Committee to consider the appointment structure of the TEAM Act.

H.R. 4261 (113th Congress), the Gulf War Health Research Reform Act of 2014 (the long title: “To improve the research of Gulf War Illness, the Research Advisory Committee on Gulf War Veterans’ Illnesses, and for other purposes”), was introduced in response to VA’s actions by then-leaders of this Committee, including then-Rep. Mike Coffman, then-Chair of the Subcommittee on Oversight and Investigations; Rep. Ann Kirkpatrick, then-Ranking Members of the Subcommittee; and then-Rep. Mike Michaud, Ranking Member of the full Committee.[16],[17]

The Gulf War Health Research Reform Act of 2014 specified the following regarding the appointment authority for the advisory committee:  “(5) Membership.— “(A) The Committee shall be composed of 12 members appointed as follows: “(i) One member appointed jointly by the chairman of the congressional veterans committees, who shall serve as chairman of the Committee.  “(ii) Two members appointed by the chairman of the Committee on Veterans’ Affairs of the House of Representatives.  “(iii) Two members appointed by the chairman of the Committee on Veterans’ Affairs of the Senate.  “(iv) Two members appointed by the ranking member of the Committee on Veterans’ Affairs of the House of Representatives.  “(v) Two members appointed by the ranking member of the Committee on Veterans’ Affairs of the Senate.  “(vi) Three members appointed by the Secretary of Veterans Affairs, of whom not less than one shall be a veteran.”

Similarly, the current TEAM Act specifies the following regarding advisory commission membership appointment authority:  “(d) Membership.— (1) (A) The Commission shall be composed of nine members, appointed as follows:  “(i) Two members appointed by the Speaker of the House of Representatives.  “(ii) Two members appointed by the minority leader of the House of Representatives.  “(iii) Two members appointed by the majority leader of the Senate.  “(iv) Two members appointed by the minority leader of the Senate.  “(v) One member appointed by the Secretary.”

When the Gulf War Health Research Reform Act of 2014 was passed by the House, then-Chairman of the House Committee on Veterans’ Affair Rep. Jeff Miller said, at the time of his request to suspend the rules and pass the legislation by unanimous consent, “It has been estimated that as many as 250,000 veterans have some form of Gulf War illness. Despite millions of dollars in government funding and years of research, it is clear that more has got to be done to better understand this disease, so we can properly care for and compensate these veterans. The bill before us today reaffirms the essential role of the Research Advisory Committee on Gulf War Veterans’ Illnesses and provides the committee with the independence that it needs, so that it can continue its vital work.”

Then-HVAC-O&I Ranking Member Rep. Kirkpatrick then said, “Congress first created the Research Advisory Committee on Gulf War Veterans’ Illnesses because the research being done at the time was considered inadequate, partially due to a mistaken belief that it was a psychological condition. Through the research, we now know that Gulf War illness is a debilitating physical condition, not something that is all in your head, as many veterans were initially told…. This bill will allow the Research Advisory Committee on Gulf War Veterans’ Illnesses to direct research and review research findings independent of the VA. It will restore the independent authority of the Research Advisory Committee by having the chairs and ranking members of the House and Senate Veterans’ Affairs Committees appoint nine members and allowing the Secretary of Veterans Affairs to appoint three members.  Additionally, the Advisory Committee will provide advice to the Secretary of Veterans Affairs and to the House and Senate Veterans’ Affairs Committees on proposed research studies, research plans, or research strategies related to the health consequences of military service during the gulf war.  Our Gulf War veterans suffer from real illnesses. These illnesses require real treatments that can only be found through proper, objective, evidence-based research. This Research Advisory Committee has the potential to find these treatments with the right combination of researchers directing and reviewing research.”

Then-HVAC-O&I Chair Rep. Coffman, the bill’s author, then added the following:

“H.R. 4261, the Gulf War Health Research Reform Act of 2014, which I sponsored along with Ranking Member Kirkpatrick and full committee Ranking Member Michaud, restores the independence of the Research  Advisory Committee on Gulf War Veterans’ Illnesses to perform the role  it has historically played, as intended by Congress, to improve the  lives of ill gulf war veterans.

This bill is necessary because some career VA staff have been trying to revive the discredited 1990s fiction that nothing special happened to gulf war veterans’ health and that the problems experienced by Gulf War veterans are just “what happens after every war” due to psychological stress factors.
Because there is no scientific evidence for this position, VA staffers have resorted to manipulating research studies and reports to try and revive this discredited theory. A major new VA gulf war veteran survey, for example, included the questions necessary to identify PTSD but not Gulf War illness.

Most shockingly, VA has even manipulated new research of the Institute of Medicine by limiting the terms of its contracts. VA transformed the Institute of Medicine gulf war treatments study ordered by Congress into a report based largely on psychotherapies. The Research Advisory Committee objected strongly to these actions, which threatened to mislead treatment research just as science is finally turning the corner. VA retaliated by eliminating the independence of the committee, changing its charter to remove its authority to review the effectiveness of government research programs, and replacing the members serving on the committee. The effect of these changes can already be seen.

The section of the new 2014 Research Advisory Committee report that detailed VA’s manipulations of research had to be removed because the committee’s authority to review the effectiveness of VA’s research programs had been eliminated.
The independent voice, so critical to honest research, will be all but replaced by September with those who seem to bend to VA’s will.   H.R. 4261 will restore the authority of the committee and provide that its membership, instead of being appointed entirely by VA, will consist of nine members appointed by the chairs and ranking members of the House Veterans’ Affairs Committee, the Senate Veterans’ Affairs Committee, and three members chosen by VA. This arrangement follows the longstanding model of the bipartisan Advisory Committee on Student Financial Assistance at the Department of Education.

Current law provides that the Research Advisory Committee membership may include veterans, representatives of veterans, and the general public. While there are those who seek to limit veteran members to ill veterans, excluding most veterans service organization representatives and others, the Research Advisory Committee has been well-served by having both ill and other veterans serve on the committee.

It is important to remember that the unwillingness of the VA to honestly address this illness is the reason Congress created the Research Advisory Committee in the first place. The 1997 congressional report that led to that legislation was entitled, “Gulf War Veterans’ Illnesses: VA, DOD Continue to Resist Strong Evidence Linking Toxic Causes to Chronic Health Effects.”

Science has made great progress since then, thanks in no small measure to the work of the Research Advisory Committee, as well as to the effective Gulf War Illness Research Program that Congress created at the Congressionally Directed Medical Research Programs. But this progress is all at risk if VA is able to again mislead science down blind alleys, directing scarce research dollars at the wrong target, as so often happened in the 1990s and 2000s.”

It is critically important that these lessons in bureaucratic power to override Congressional intent and law not be forgotten.  As Congress moves to craft comprehensive toxic exposures legislation, we respectfully remind the Committee of these lessons learned but too-easily forgotten.  While restorative legislation like the Gulf War Health Research Reform Act of 2014   should not have been necessary, unfortunately, it was.  Regrettably, the Senate at the time had concerns about the type of appointment authority that it specified.

For the committees created under this legislation, we strongly encourage the Committee to consider alternatives to VA-only appointment authority, similar to that in the TEAM Act and the Gulf War Health Research Reform Act of 2014.

We also strongly encourage the Committee to consider adding commissioning and consideration of animal studies of toxic exposure to the list of authorities granted to the Science Review Board or Working Group under section 1174.  As described in more detail elsewhere in this written testimony and prior written testimony submitted to the Committee, animal studies of toxic exposure are critical for determining plausible mechanisms of action and adverse health outcomes of certain toxic exposures, particularly those for which there is a paucity of human data and it would be unethical to expose humans for the purposes of determining adverse human health outcomes.  It is worth noting that VA has consistently resisted such inclusion or consideration, even while VA’s Office of Research and Development has funded some excellent animal studies modeling toxic exposures.

In considering the provisions of this bill related to the Science Review Board (Sec. 1173), it is notable that there is an absence of discussion regarding criteria for determining the acceptability or non-acceptability of studies allowable for consideration for the Board’s work.  Historically, the VA-contracted NAS/NASEM has excluded consideration of the vast majority of relevant studies in its reviews of peer-reviewed published study results.  Such reviews have generally also not included consideration of unpublished VA statistical data.  It may be worth the Committee’s consideration to determine whether such issues merit specification in ultimately enacted legislation.

  

H.R. 2742 – PFAS Registry Act

This legislation would establish a registry for eligible individuals related to PFAS exposure.

We would remind the members of the Committee of the legislative priorities of Vietnam Veterans of America provided in VVA testimony at a joint hearing of the House and Senate Committees on Veterans’ Affairs earlier this year, specifically with regards to concerns related to “real” health registries – capable of being used for epidemiological research rather than serving merely as VA mailing lists.   Veterans for Common Sense shares and echoes these concerns and priorities.  We also note the extended incubation period for many health conditions associated with particular exposures.

Clearly this legislation is well intentioned.  Additional benefits of registries could be added by the Committee to include requiring VA to provide initial and follow-up health exams; requiring VA to establish the registry created under this legislation sufficiently to enable epidemiological study of registrants, in keeping with VVA’s legislative priorities; making exposure to PFAS presumptive for veterans at known locations where PFAS exposure was at least as likely as not; and ensuring all the various best practices for registries identified in NASEM-published reports reviewing VA registries.

Veterans for Common Sense thanks Rep. Pappas, Rep. Fitzpatrick, Rep. Delgado, and Rep. Kuster for introducing the PFAS Registry Act.

  

H.R. 2825 – Fort McClellan Health Registry Act

 Veterans with serious adverse health outcomes who served at Fort McClellan have long complained of the lack of attention to their justified concerns.  Fort McClellan was home to chemical and biological weapons training programs.  Various reviews over the years have revealed extensive chemical and radiological contamination at Fort McClellan.  Additionally, the Anniston Army Depot near Fort McClellan maintained a stockpile of chemical weapons.  Additionally, there was Monsanto chemical production facility in Anniston until the 1970s which may have been a source of further toxic exposure, including to PCB’s.

This legislation would establish a registry for eligible individuals related to toxic exposures sustained during military service at Fort McClellan, including requiring VA to provide initial health exams.  Veterans for Common Sense supports this legislation and commends Rep. Tonko for introducing the Fort McClellan Health Registry Act.

We would remind the members of the Committee of the legislative priorities of Vietnam Veterans of America provided in VVA testimony at a joint hearing of the House and Senate Committees on Veterans’ Affairs earlier this year, specifically with regards to concerns related to “real” health registries – capable of being used for epidemiological research rather than serving merely as VA mailing lists.   Veterans for Common Sense shares and echoes these concerns and priorities.  We also note the extended incubation period for many health conditions associated with particular exposures.

Clearly this legislation is well intentioned.  Additional benefits of registries could be added by the Committee to include requiring VA to provide follow-up health exams; requiring VA to establish the registry created under this legislation sufficiently to enable epidemiological study of registrants, in keeping with VVA’s legislative priorities; making exposure to toxins known to have been at Fort McClellan presumptive for veterans where such exposure was at least as likely as not; and ensuring all the various best practices for registries identified in NASEM-published reports reviewing VA registries.
 

(S. 1039) – Improving Benefits for Gulf War Veterans Act:

While a companion to this Senate legislation has not yet been introduced in the house, we would like to provide the Committee with our written testimony about this legislation provided to the Senate Committee on Veterans’ Affairs for their April 28, 2021 hearing on pending legislation that included this bill.  We encourage the House Committee on Veterans’ Affairs to consider including these provisions in any legislation emanating from the Committee this year.

Veterans for Common Sense strongly supports this bills’ provision to make permanent the period for filing Gulf War related claims.  VA has provided multiple five-year extensions to date, and we understand is currently working on another.  However, medical research has consistently shown that the health of veterans with Gulf War Illness is not improving and is likely worsening.  After 30 years, there is little justification that any more study is needed as to whether Gulf War veterans are ill.

Veterans for Common Sense strongly supports the provision in this legislation that would extend eligibility to VA benefits and healthcare currently available to most Gulf War veterans to also include veterans with qualifying service in Afghanistan, Egypt, Israel, Jordan, Syria, and Turkey.  Veterans for Common Sense published an analytical issue paper in 2017 which may be of interest to the Committee regarding Gulf War veterans issued the Southwest Asia Service Medal (SWASM) but not included as Gulf War veterans by VA for healthcare and benefits purposes.[18]  It remains unclear to us why these Gulf War veterans awarded the SWASM for their Gulf War service were not initially included by VA in 1994 as Gulf War veterans.  We have long sought a remedy for these veterans and are grateful for its critically important inclusion here.

We note that as currently drafted, this legislation would not also grant coverage to veterans with service in the airspace above or the contiguous waters of these added six countries.  This is the result of the technical interplay between the wording added to 38 USC 1117 by this legislation and 38 CFR 3.317, which includes the current geographic definition for covered veterans.  We would be happy to work with the Committee on this issue.

Veterans for Common Sense strongly supports the reduction in threshold for eligibility provided by this bill.

Veterans for Common Sense strongly supports the bill’s requirement for a single Disability Benefits Questionnaire (DBQ) for Gulf War Illness symptoms and issues.  Since the 1994 enactment of legislation making “undiagnosed illnesses” (UDX) presumptive for VA compensation claims, VA’s high denial rates of these claims have persisted.  VA’s denials of presumptive “medically unexplained chronic multisymptom illness” (MUCMI) claims remain a serious issue for the denied veterans.  A 2017 GAO report and related House Veterans’ Affairs Committee hearing at which we testified showed a roughly 90 percent denial rate of UDX claims and a denial rate nearly as high for MUCMI claims.[19]  VA is no longer publicizing benefits utilization data, including claims grant and denial rates, so there is no reason to believe there have been substantial improvements.

Given the persistent high rates of denial of GWI claims, Veterans for Common Sense has recommended the creation of a symptom-based schedule of ratings for symptoms-based disabilities like Gulf War Illness. We have suggested that it be modeled at least loosely upon the current schedule of ratings for traumatic brain injury (TBI), with “buckets” of types of symptoms and a points-based system for rating disability.  Such a schema could also be applied to veterans with toxic exposure-related symptoms that do not current (or do not yet) meet diagnostic criteria for existing diseases.  Again, we would be happy to work with the Committee in this regard.

Veterans for Common Sense strongly supports the bill’s provisions regarding training for VA personnel.  We recommend that the bill’s language be expanded to cover VBA benefits personnel in addition to the VA health care personnel currently specified in the bill.

In keeping with the goals and recommendations stated above, Veterans for Common Sense strongly supports S. 103, the Improving Benefits for Gulf War Veterans Act.  Veterans for Common Sense is deeply grateful to Senator Menendez for the introduction of this legislation.  Veterans for Common Sense is also deeply grateful to the Veterans of Foreign Wars (VFW) for the strong support of this legislation.

CONCLUSION:

It is critically important that these lessons from relatively recent history not be forgotten.  And, while Congress works to craft comprehensive toxic exposures legislation and seeks to remedy the unremedied wrongs of multiple past exposures, we respectfully remind the Committee that many of the issues afflicting Gulf War veterans have yet to be resolved despite multiple hearings by this Committee in the last decade:

  • An unworkable “undiagnosed illness” presumption, with near-total VA claims denials.
  • VA denials of roughly 80 percent of “medically unexplained chronic multi-symptom illness” (MUCMI) claims.
  • No viable VA schedule of ratings for symptom-based conditions that do not yet match a standard medical diagnosis.
  • No viable disability benefits questionnaire (DBQ) for symptom-based conditions that do not yet match a standard medical diagnosis.
  • VA cessation of public reporting of VA healthcare and benefits utilization data and atrocious Freedom of Information Act (FOIA) responses, making it difficult to impossible for veterans service organizations (VSOs), Congress, and the public to identify VA progress – or lack thereof – in addressing and improving high denial rates related to toxic exposure claims.
  • VA’s continued failures with the Research Advisory Committee on Gulf War Veterans’ Illnesses currently housed under VA (but not necessarily so), including failure to restore its charter and scope to the original Congressional intent as described above.
  • VA’s failures in contracting with NAS/NASEM, including failure to consider animal studies of toxic exposures in determining plausibility of adverse health outcomes and strength of association with toxic exposures.
  • No presumed exposures for Gulf War veterans, despite the long lists legislated by Congress that were considered by flawed NAS reviews.
  • Few presumptive conditions for Gulf War veterans – none added in over a decade and essentially none of relevance added by VA for veterans with Gulf War Illness – due to the lack of presumed exposures, the flawed VA-NAS process, and the too-high bar for strength of association.

We are highly encouraged by the momentum in both houses of Congress to enact comprehensive toxic exposures legislation.  We hope that the lessons to be learned from the relatively recent past will not be forgotten, and that as many issues as possible can be related to toxic exposure can be resolved.

We remain ready to assist the Committee in these regards.  Thank you again for this opportunity to provide our experience-based recommendations.


FOOTNOTES:

[1] House Veterans’ Affairs Committee, Subcommittee on Oversight and Investigations and Subcommittee on Disability Assistance and Memorial Affairs, March 15, 2016, “Twenty-Five Years After The Persian Gulf War: An Assessment Of VA’s Disability Claims Process With Respect To Gulf War Illness”: https://archives-veterans.house.gov/submission-record/aanthony-hardie-gulf-war-veteran-and-director-veterans-common-sense

[2] H.HRNG 37-476, House Committee on Veterans’ Affairs, Subcommittee on Health, “Gulf War Exposures”, July 26, 2007: https://www.govinfo.gov/content/pkg/CHRG-110hhrg37476/html/CHRG-110hhrg37476.htm

[3] http://veteransforcommonsense.org/wp-content/uploads/2020/02/Conditions-Associated-with-Gulf-War-exposures-consolidated-NAS-IOM-listing.pdf

[4] Persian Gulf War Veterans Act of 1998 [Title XVI, P.L. 105-277, “Omnibus Consolidated and Emergency Supplemental Appropriations Act, 1999”], Sec. 1603(d) [“Initial Consideration of Specific Agents”].

[5] Persian Gulf War Veterans Act of 1998 [Title XVI, P.L. 105-277, “Omnibus Consolidated and Emergency Supplemental Appropriations Act, 1999”], Sec. 1603(d) [“Initial Consideration of Specific Agents”].

[6] https://cholangiocarcinoma.org/risk-factors/

[7] H.HRNG. 113-9, Subcommittee on Oversight and Investigations, House Committee on Veterans’ Affairs, March 13, 2013, “Gulf War: What Kind of Care Are Veterans Receiving 20 Years Later?” https://www.govinfo.gov/content/pkg/CHRG-113hhrg79944/html/CHRG-113hhrg79944.htm

[8] https://archives-veterans.house.gov/witness-testimony/dr-steven-s-coughlin

[9] As an aside, the year after that HVAC-O&I hearing, Dr. Coughlin was awarded the Research Integrity Award by the International Society for Environmental Epidemiology, and the Deployment Health Researcher of the Year Award by the Sergeant Sullivan Center.  Since that time, he is also the recipient of multiple research grants, including from DoD related to toxic exposure epidemiology, and has published his important results in peer-reviewed medical journals.

[10] NAAV website:  https://www.naav.com

[11] Stars and Stripes, “Conspiracy of silence: Veterans exposed to atomic tests wage final fight,” by Claudia Grisales, June 16, 2019: https://www.stripes.com/news/special-reports/conspiracy-of-silence-veterans-exposed-to-atomic-tests-wage-final-fight-1.585789

[12] Ola Landgren, Youn K Shim, Joel Michalek, Rene Costello, Debra Burton, Norma Ketchum, Katherine R Calvo, Neil Caporaso, Elizabeth Raveche, Dan Middleton, Gerald Marti, Robert F Vogt Jr, JAMA Oncol, “Agent Orange Exposure and Monoclonal Gammopathy of Undetermined Significance: An Operation Ranch Hand Veteran Cohort Study,” 2015 Nov;1(8):1061-8.  https://doi.org/10.1001/jamaoncol.2015.2938.

[13] https://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25137.  See: National Academies of Sciences, Engineering, and Medicine. 2018. Veterans and Agent Orange: Update 11 (2018). Washington, DC: The National Academies Press. https://doi.org/10.17226/25137.

[14] 113th Congress, H.R. 4261.  See further in this statement for the record for more details.

[15] For example, DoD GW160154, “Identifying Novel Immune and Radiographic CT Imaging Signatures of Chronic Bronchiolitis”: https://cdmrp.army.mil/search.aspx?LOG_NO=GW160154

[16] https://www.congress.gov/congressional-record/2014/05/28/house-section/article/H4863-1

[17] https://www.congress.gov/bill/113th-congress/house-bill/4261/text

[18] http://veteransforcommonsense.org/wp-content/uploads/2019/05/ISSUE-Resolving-Differences-in-Definitions-of-Persian-Gulf-War-Veteran-.pdf

[19] https://docs.house.gov/Committee/Calendar/ByEvent.aspx?EventID=106223

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80 Members of Congress, 25 Organizations Call for Funding to Help Veterans with Gulf War Illness

(Washington – April 30, 2021) – This week, 80 Members of Congress called for funding to help veterans with Gulf War Illness.  Led by Representatives Gregorio Kilili Camacho Sablan (D-MP) and Jack Bergman (R-MI), the bipartisan effort in support of a treatment research program targeted at “improved health and lives of Veterans who have Gulf War Illness” comes in the midst of a series of Congressional hearings on military toxic exposures.

In a joint letter, the cosigners urged the Defense Appropriations Subcommittee to provide funding needed “to continue this vital and effective program and to support its progress into more advanced, larger-scale clinical trials,” calling it, “a model of how to conduct treatment-oriented research to address complex toxic exposure health outcomes.”  The Congressional efforts were supported by 25 organizations, including veterans and military service organization and toxic exposure advocacy organizations, who this week cosigned their own similar letter to the Defense Appropriations Subcommittee.

“Veterans with Gulf War Illness have suffered for far too long,” said Rep. Gregorio Kilili Camacho Sablan (D-MP).  “We must do all that is needed now to help all our veterans suffering the health effects of their military toxic exposures.  That includes fully funding critically important treatment research programs to improve their health and lives, including this one for veterans suffering from Gulf War Illness,” he said.

“Veterans who’ve served our country are suffering from Gulf War Illness (GWI), but much progress has been made towards treatment and understanding through the successful Gulf War Illness Research Program (GWIRP) within the Department of Defense (DoD) Congressionally Directed Medical Research Programs (CDMRP).  It’s imperative we do everything we can to ensure those who have sacrificed so much for our Nation have access to the care and treatment they deserve. I am grateful that Rep. Kilili Sablan has helped lead this effort as we seek to do right by our Veterans,” said Rep. Jack Bergman (R-MI).

“The progress being made to develop treatments is highly encouraging for veterans suffering from Gulf War Illness,” said Anthony Hardie, National Chair & Director of Veterans for Common Sense and an ill Gulf War veteran himself.  “That progress is thanks in very large part to the work of Reps. Kilili Sablan and Jack Bergman, Sen. Tammy Baldwin, and the many powerful cosigners in the House and Senate who help to secure this funding, and to whom we are deeply grateful.  And, the support of more than two dozen veterans, military, and toxic exposure organizations is incredible.  In short, the critical work of the program staff and brilliant researchers to actually develop effective treatments for Gulf War Illness would not be possible without such a broad base of powerful support,” said Hardie.

“Sandwiched between Agent Orange and Burn Pits, Gulf War illness is often the forgotten disability.  Although more than three decades have passed, since the end of the Gulf War, we still have not solved the virulent toxic impact on the health of Gulf War veterans.   The current bipartisan support for the Gulf War Illness Research Program (GWIRP) is heartening.  We must continue to fund this critical research and Military-Veterans Advocacy calls on Congress to include appropriate levels of funding in the 2022 National Defense Authorization Act.”  – Commander John B. Wells, U. S. Navy (Retired), Attorney at Law and Chairman of Military-Veterans Advocacy, Inc.

“The significance of the Gulf War Illness Research Program (GWIRP) cannot be overstated. We greatly appreciate the solid support that has been demonstrated for this vital program which represents a critical resource in the efforts to find successful treatments for these terrible conditions,” said National Veterans Legal Services Program Executive Director Bart Stichman.

“The Gulf War Illness Research Program is an outstanding model of effectiveness for how to go about research to treat and prevent toxic exposure conditions like Gulf War Illness.  The impact of treatment research is critical for sick veterans who come home affected by their toxic exposure health issues, including our son in whose memory and legacy our organization was named.”  –Peter Sullivan, Director, The Sergeant Sullivan Circle.

“This is a critical research program that is needed and can be built upon to provide future research for other illnesses caused by toxic exposures.  We thank Rep. Sablan, Rep. Bergman and the many cosigners for their support in advocating for funds for this critical program,” said Holly Ferrell, Executive Director, Veteran Warriors.

“United Soldiers and Sailors of America strongly believes that our service members and our veterans are our greatest national treasure and that the Gulf War Illness treatment research (GWIRP) is urgently needed to ensure that our nation and our people provide them with the care, compassion and support that they have earned and deserve,” said John P. Yori, President of United Soldiers and Sailors of America – USASOA.

“Veterans and Military Families for Progress (VMFP) fully support this effort. We thank the House, Senate and the Veterans Service Organizations (VSO) community, for combining to end the absurd, meaningless outrageous and detrimental delay in caring for our Veterans with toxic exposure issues. Hopefully, this will put an end, once and for all, to the misguided efforts by of the Department of Veterans Affairs (VA) defying logic and the disregard the needs of people exposed to toxins. With it, we also hope it will end the anguish of their families and other people in their community, dealing who have with all these problems for so long.”  –Matt Cary, Executive Director, Veterans and Military Families for Progress.

“The research done thru DOD CDMRP GWIRP is doing the hard work we wanted from the time our service members returned from Operation Desert Storm in 1991.  We wanted acknowledgement of exposures and to be able to know where physical damage occurred due to military toxic exposures. The medical researchers have found answers and are racing to find treatments to stop progression of symptoms that will advance to bad diagnosed conditions. We all have a goal to decrease suffering, improve the veterans’ quality of life, and to restore their health. We cannot and will not give up because the veterans did not and they accomplished their goals. We must continue to give our all as they have theirs. It is a debt we pay that is past due.” –Denise Nichols, MAJ, USAF(Ret), RN(Ret), BSN, MSN and disabled veteran, Gulf War Illnesses Advocate, National Vietnam and Gulf War Veterans Coalition.

“It is past time to provide the critical care to our nation’s veterans affected by these exposures.  Congress needs to act to on its promises to our service members and provide the care necessary for them,” said Jane Williams, Executive Director of California Communities Against Toxics.

 

Background:

By congressional design, the Gulf War Illness Research Program (GWIRP), created by Congress as a Congressionally Directed Medical Research Program (CDMRP) within the Department of Defense (DoD), is a unique medical research program narrowly focused on identifying treatments and diagnostic markers for Gulf War Illness (GWI).

As many as one-third of the roughly 700,000 veterans of the 1990-91 Gulf War suffer from Gulf War Illness, according to research findings and the DoD webpage for the Gulf War Illness Research Program.

According to that DoD webpage, GWI is characterized by multiple, diverse symptoms that typically include chronic headache, widespread pain, cognitive difficulties, debilitating fatigue, gastrointestinal problems, respiratory symptoms, sleep problems, and other abnormalities that could not be explained by established medical diagnoses or standard laboratory tests.”

Numerous research studies have found that the condition likely resulted from toxic exposures in the Gulf War theater of operations.

These Congressionally Directed Medical Research Programs, including the Gulf War Illness Research Program, are unique in that they include “consumer reviewers,” patients afflicted by the health condition, at every step of decision-making.  These consumer reviewers, who offer unique insight, focus, and a sense of urgency, help the program to decide which research will be funded to best meet the needs of patients affected by the debilitating health condition.

The following House Members also supported this request, which was led by Reps. Gregorio Kilili Camacho Sablan (D-MP) and Jack Bergman (R-MI):  Reps. Colin Allred (D-TX), Gus M. Bilirakis (R-FL), Lisa Blunt Rochester (D-DE), Mike Bost (R-IL), Anthony G. Brown (D-MD), Julia Brownley (D-CA), Vern Buchanan (R-FL), Cheri Bustos (D-IL), Tony Cárdenas (D-CA), André Carson (D-IN), Sean Casten (D-IL), Judy Chu (D-CA), Jim Costa (D-CA), Angie Craig (D-MN), Jason Crow, (D-CO), Danny K. Davis (D-IL), Madeleine Dean (D-PA), Peter A. DeFazio (D-OR), Diana DeGette (D-CO), Antonio Delgado (D-NY), Mark DeSaulnier (D-CA), Debbie Dingell (D-MI), Lloyd Doggett (D-TX), Veronica Escobar (D-TX), Anna G. Eshoo (D-CA), Ruben Gallego (D-AZ), Jesús G. “Chuy” García (D-IL), Jenniffer González-Colón (R-PR), Paul A. Gosar, D.D.S., (R-AZ), Raúl M. Grijalva (D-AZ), Jahana Hayes (D-CT), Sheila Jackson Lee (D-TX), Pramila Jayapal (D-WA), Bill Johnson (R-OH), Eddie Bernice Johnson (D-TX), Rep. John Katko (R-NY), William R. Keating (D-MA), Trent Kelly (R-PA), Ro Khanna (D-CA), Ron Kind (D-WI), Raja Krishnamoorthi (D-IL), Ann McLane Kuster (D-NH), Rick Larsen (D-WA), Barbara Lee (D-CA), Alan Lowenthal (D-CA), Stephen F. Lynch (D-MA), James P. McGovern (D-MA), Gregory W. Meeks (D-NY), Gwen Moore (D-WI), Richard E. Neal (D-MA), Eleanor Holmes Norton (D-DC), Ilhan Omar (D-MN), Jimmy Panetta (D-CA), Chris Pappas (D-NH), Donald M. Payne, Jr. (D-NJ), Greg Pence (R-IN), Chellie Pingree (D-ME), Stacey E. Plaskett (D-VI), Aumua Amata C. Radewagen (R-AS), Jamie Raskin (D-MD), Kathleen M. Rice (D-NY), Cathy McMorris Rodgers (R-WA), Raul Ruiz, M.D., (D-CA), Bobby L. Rush (D-IL), Linda T. Sanchez (D-CA), Jan Schakowsky (D-IL), Mikie Sherrill, (D-NJ), Albio Sires, (D-NJ), Elissa Slotkin (D-MI), Christopher H. Smith (D-NJ), Darren Soto (D-FL), Jackie Speier (D-CA), Thomas R. Suozzi, (D-NY), Mark Takano (D-CA), Rashida Tlaib (D-MI), Marc Veasey (D-TX), Peter Welch (D-VT), and John Yarmuth (D-KY).

The following organizations cosigned in support of this effort:  DAV, Veterans of Foreign Wars, Blinded Veterans Association, Burn Pits 360, California Communities Against Toxics, Cease Fire Campaign, Fleet Reserve Association, Iraq and Afghanistan Veterans of America, Jewish War Veterans of the USA, Military Order of the Purple Heart, Military-Veterans Advocacy, National Veterans Legal Services Program, National Vietnam & Gulf War Veterans Coalition, Paralyzed Veterans of America, the Quinism Foundation, Reserve Organization of America (ROA), Sergeant Sullivan Circle, Service Women’s Action Network (SWAN), Tragedy Assistance Program for Survivors (TAPS), United Soldiers and Sailors of America, Veterans for Common Sense, Veterans and Military Families for Progress, Veteran Warriors, VetsFirst, and Vietnam Veterans of America.

# # #


RELATED NEWS STORIES:

Members of Congress and veteran groups call for more funding for Gulf War illness research, Bradenton (FL) Herald, May 4, 2021

How Gulf War illness research could aid study of red tide, Bradenton (FL) Herald, May 4, 2021

PRESS RELEASE:  BERGMAN, SABLAN LEAD 80 MEMBERS OF CONGRESS, 25 ORGANIZATIONS IN CALL FOR FUNDING TO HELP VETERANS WITH GULF WAR ILLNESS, Office of Rep. Jack Bergman, May 3, 2021

Bergman, Sablan lead 80 members of Congress, 25 organizations in call for funding to help veterans with Gulf War Illness, The Daily Mining Gazette (MI), May 7, 2021

 


 

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Veterans for Common Sense provides Testimony for Senate Hearing on Pending Legislation

Veterans for Common Sense provided the following testimony for an April 28, 2021 hearing of the Senate Committee on Veterans’ Affairs on pending legislation.


[download PDF]

Statement for the Record of  Veterans for Common Sense
 by Anthony HardieNational Chair and Director
before the Senate Committee on Veterans’ Affairs
Regarding a Hearing on Pending Legislation
April 28, 2021

Thank you, Chairman Tester and Ranking Member Moran for this hearing regarding pending legislation. We are grateful for this opportunity to provide written testimony for the record.

Veterans for Common Sense is national veterans’ organization focused on education and advocacy on behalf of veterans, military service members, and historically has helped to elevate veterans’ voices in national policy discussions.  Our national board of directors includes most of the leaders of the national Gulf War veterans organization formed in 1995. Our efforts resulted in the creation of critical Gulf War legislation and related measures, including the seminal Persian Gulf War Veterans Act of 1998 and the Gulf War provisions of the Veterans Programs Enhancement Act of that same year.

We appreciate the opportunity to share our views, today in particular, from the perspectives of Gulf War veteran advocates and veterans affected by Gulf War toxic exposures and the resultant Gulf War Illness.  We hope that our testimony today can help illuminate lessons learned from the experiences of this often-overlooked cohort.  We include eight (8) such “lesson learned”

In 1996, we developed a five-point plan at our first national conference of our coalescent national coalition of grassroots groups of ill Gulf War veterans and their loved ones.  Our step-by-step plan included the following:

1) INVESTIGATION: an investigation into what happened to us Gulf War troops including to what we may have been exposed;

2) RESEARCH:  medical research to determine the health outcomes associated with each exposure;

3) TREATMENT:  effective treatment for the health outcomes associated with each exposure (later to be described as “evidence-based” treatment);

4) CLAIMS:  an appropriate VA claims process to ensure that VA provided compensation for Gulf War-incurred disabilities that were long-term or permanent;

5) NEVER AGAIN:  a pledge based on that of the Vietnam Veteran veterans who came before us – that never again should what happened to us be allowed to happen again.

In short, our plan was fairly simple to articulate:  Investigation, Research, Treatment, Compensation, and Never Again.  That plan was to serve as an early framework for our 1998 legislation.  The 1998 legislation is described below, drawn from testimony we provided in 2016:[1]

 

1998 PERSIAN GULF WAR VETERANS LEGISLATION

 As I noted in my testimony of February 23 [2016], it took almost eight years after the war before Gulf War veteran’ major legislative victory, with the enactment of the Persian Gulf War Veterans Act of 1998 (Title XVI, PL 105-277) and the Veterans Programs Enhancement Act of 1998 (PL 105-368, Title I—“Provisions Relating to Veterans of Persian Gulf War and Future Conflicts”) – two landmark bills that set the framework for Gulf War veterans’ healthcare, research, and disability benefits.

For those of us involved in fighting for the creation and enactment of these laws, they seemed clear and straightforward, with a comprehensive, statutorily-mandated plan that would guarantee research, treatments, appropriate benefits, and help ensure that lessons learned from our experiences would result in never again allowing what happened to us to happen to future generations of warriors.

The legislation included a long list of known Gulf War exposures.  VA was to presume our exposure to all of these, and then, with the assistance of the National Academy of Sciences (NAS), evaluate each exposure for associated adverse health outcomes in humans and animals.  In turn, the VA Secretary would consider the reports by the NAS’s Institute of Medicine (IOM), “and all other sound medical and scientific information and analyses available,” and make determinations granting presumptive conditions.  There was a new guarantee of VA health care. There would also be a new national center for the study of war-related illnesses and post-deployment health issues, which would conduct and promote research regarding their etiologies, diagnosis, treatment, and prevention and promote the development of appropriate health policies, including monitoring, medical recordkeeping, risk communication, and use of new technologies. There was to be an effective methodology for treatment development and evaluation, a medical education curriculum, and outreach to Gulf War veterans.  Research findings were to be thoroughly publicized.  To ensure the federal government’s proposed research studies, plans, and strategies stayed focused and on track, VA was to appoint a research advisory committee that included Gulf War veterans – presumably those who were ill and affected – and their representatives.

Instead, we learned that enactment of those laws was just another battle in our long war.

From the beginning, VA officials fought against implementing these laws, dragging their feet and upending their implementation.

In addition to the failures I noted in my February 23 [2016] testimony, the process for determining presumptions has failed to yield new presumptions without Congressional intervention.  And, the laws aimed at providing at clear path for Gulf War veterans’ compensation by VA while awaiting the development of effective treatments has been not just problematic, but with extraordinarily high denial rates, as VA’s own data shows and as will be discussed below.

For Gulf War veterans, getting VA to approve a disability claim for a presumptive condition has been nearly impossible for most.  And, as with all denied VA claims, the backlog of appealed claims is daunting and adds years to the process.

That leads now to a discussion of components drawn from Gulf War veterans’ experience and the lessons that can be learned for advancing new legislation related to toxic exposures:

A.  Access to care.   Prior to our 1998 legislation, the ability of veterans was very limited for accessing VA healthcare unless they had an already-approved claim for VA compensation or pension.  Of course, medical evidence was required to win a compensation claim, but without access to healthcare, it was difficult to impossible to receive needed healthcare.

The 1998 legislation provided for two years of VA healthcare for combat veterans.  Later legislation expanded that period to five years.  Of great importance, the TEAM Act would significantly expand that care for veterans with toxic exposures.

LESSON LEARNED1) Granting VA healthcare access to veterans with toxic exposures is critical.

 

Treatment-focused Research.  However, related to accessing healthcare and as I testified before a House Veterans’ Affairs Subcommittee on Health hearing in 2007, while it was certainly possible “for Gulf War veterans to be seen at VA medical facilities, however, being seen is not the same as being treated.”[2] [emphasis added]

For many Gulf War veterans suffering the adverse health effects of Gulf War toxic exposures, science and medicine did not yet have answers for why they were sick or how to treat their illness.  This remains the case not only for far too many Gulf War veterans, but also for many veterans with burn pits and other toxic exposures.

Even worse, health risk communications publicized by the Department of Defense (DoD) and VA consistently minimized the association between Gulf War service and the adverse health outcomes so many of us were experiencing.  Similar minimization continues even through to the present: alleging no clear links have been found associating deployment or exposures or deployment with adverse health outcomes, “more research is needed,” legislation seeking to resolve these issues is “premature”.  This persistent denial messaging only serves to anger the already injured veteran population.

While the story is too long to tell in this statement, eventually Gulf War veterans benefitted from the creation of the Gulf War Illness Research Program (GWIRP), one of the Congressionally Directed Medical Research Programs (CDMRP) created and funded by Congress through annual Department of Defense Health Agency appropriations.  For reasons that have been provided in detail in past House Veterans’ Affairs Committee hearings, it was and remains of critical importance that this program remains outside of VA.  A Burn Pits Exposure topic area within the Peer Reviewed Medical Research CDMRP (PRMRP) and other disease- and exposure-specific research programs and approved topic areas remain of equally critical importance.  We are deeply grateful to Congress for continuing to support these critically important medical research programs.

Also of critical importance is streamlining the process to speed successful research treatments and diagnostic findings to clinicians treating the patients who are affected.  As effective treatments for Gulf War Illness and other toxic exposures and conditions are found, processes to add evidence-based treatments to VA’s formulary and clinical practice must be enhanced.

LESSON LEARNED:  2) Funding treatment-focused medical research aimed at improving health and lives – and bench-to-bedside translational efforts to speed research successes to clinical care – is critically important to ensure veterans being “seen” by VA clinicians are provided with evidence-based healthcare that in fact improves their health and lives.

 

B. Framework for determining new presumptive conditions.

The 1998 Gulf War legislation provided a framework for determining presumptive conditions for VA compensation claims.  That framework should have provided a clear path for additional deployment- or exposure-associated conditions to be determined by the VA Secretary, based on reports from the NAS, as “presumptive”.

Through this framework, the National Academy of Sciences, Engineering, and Medicine (NASEM) has released numerous literature reviews of Gulf War research.  Most of these reports include conclusions regarding the strength of association between deployment to the Gulf War or Gulf War exposures and particular health outcomes.

The five categories are:

  • Sufficient evidence of a causal relationship, that is, the evidence is sufficient to conclude that between being deployed to the Gulf War causes a health outcome.
  • Sufficient evidence of an association; that is, a positive association has been observed between deployment to the Gulf War and a health outcome in humans.
  • Limited/suggestive evidence of an association; that is, some evidence of an association between deployment to the Gulf War and a health outcome in humans exists.
  • Inadequate/insufficient evidence to determine whether an association exists; that is, available studies are of insufficient quality, validity, consistency or statistical power to permit a conclusion regarding the presence or absence of an association.
  • Limited/suggestive evidence of no association; that is, several adequate studies are consistent in not showing an association between deployment and a health outcome.

For Gulf War veterans, the bar for determining these conditions as “presumptive” has been too high and few conditions have met this bar.

Veterans for Common Sense has compiled a complete list[3] of all conditions considered by NAS in the Gulf War and Health series, comprising over 400 exposures, along with their NAS categories of association.  Nearly all fall in the lower three tiers of NAS strength of association determinations.

LESSON LEARNED: 3) A presumptive condition determination framework should set the bar at the “Limited/suggestive evidence of an association” level

 

C. List of exposures. The Persian Gulf War Veterans Act of 1998 provided a list of 32 potential exposures for Gulf War veterans.

(A) The following organophosphorous pesticides: (i) Chlorpyrifos.  (ii) Diazinon.  (iii) Dichlorvos.  (iv) Malathion.  (B) The following carbamate pesticides: (i) Proxpur.  (ii) Carbaryl.  (iii) Methomyl.  (C) The carbamate pyridostigmine bromide used as nerve agent prophylaxis.  (D) The following chlorinated hydrocarbons and other pesticides and repellents: (i) Lindane.  (ii) Pyrethrins.  (iii) Permethrins.  (iv) Rodenticides (bait).  (v) Repellent (DEET).  (E) The following low-level nerve agents and precursor compounds at exposure levels below those which produce immediately apparent incapacitating symptoms: (i) Sarin.  (ii) Tabun.  (F) The following synthetic chemical compounds: (i) Mustard agents at levels below those which cause immediate blistering.  (ii) Volatile organic compounds.  (iii) Hydrazine.  (iv) Red fuming nitric acid.  (v) Solvents.  (vi) Uranium.  (G) The following ionizing radiation: (i) Depleted uranium.  (ii) Microwave radiation.  (iii) Radio frequency radiation.  (H) The following environmental particulates and pollutants: (i) Hydrogen sulfide.  (ii) Oil fire byproducts.  (iii) Diesel heater fumes.  (iv) Sand micro-particles.  (I) Diseases endemic to the region (including the following): (i) Leishmaniasis.  (ii) Sandfly fever.  (iii) Pathogenic escherichia coli.  (iv) Shigellosis.[4]

D. Concession of exposures. As directed by the law, VA contracted with the NAS for reviews of these exposures (and not limited to these exposures) and whether Gulf War veterans “may have been exposed.” In report after report in the NAS’s “Gulf War and Health” series, the NAS was unable to determine actual levels of exposure for Gulf War troops, including dose-response relationships, due in large part to flawed, inadequate, and incomplete troop location data, lost troop medical and other records, inadequate environmental sampling data, and so on.

Unfortunately for Gulf War veterans, the list of 32 exposures in the enacted legislation and resulting law[5] did not rise to the level of an actual concession of exposures.  Instead, the enacted legislation used indeterminate language: “may have been exposed”; “may have been exposed for purposes of any report under subsection…”.

The end result of the Gulf War framework has been deeply disappointing to Gulf War veterans:  no concessions of exposure to any of the toxic and hazardous exposures identified by Congress in law (with the exception of nine rare endemic infectious diseases, which have been of little consequence for most veterans deployed to the theatre of operations) and essentially no new presumptive conditions resulting from that framework.

Thus, Gulf War veterans have never received the same benefit of a concession of exposures granted to Agent Orange veterans, and as would be granted — to a more limited extent – by pending toxic exposures legislation.  That task probably falls to Congress to determine.  To date, Gulf War veteran reliance on DoD and VA to concede exposures has not succeeded despite a carefully articulated and well-intentioned framework enacted in the 1998 legislation.

LESSONS LEARNED:  4) Conceding exposures is critical, and that task probably falls to Congress to legislate.

 

E.  Plausibility of etiology. An important method for determining the plausibility of adverse health outcomes has been the use of experimental models of exposures.  These models have primarily involved the use of experimental rats and mice, though others have used cockroaches, cell lines, and machine learning.

We have provided extensive prior testimony on this critical aspect of any NAS or similar studies to determine the association between exposures (or deployment) and health outcomes.

See:  “Statement for the Record of James Binns, Roberta White, Anthony Hardie, & Paul Sullivan for a September 23, 2020 Hearing of the Committee on Veterans’ Affairs, Subcommittee on Disability Assistance and Memorial Affairs, Entitled: “Toxic Exposures: Examining Airborne Hazards In The Southwest Asia Theater Of Military Operations”.

LESSON LEARNED:  5) Animal studies of toxic exposure are critical to understanding plausible health outcomes associated with toxic exposures.

 

F.  List of Presumptive Conditions.

Gulf War legislation enacted in 1994 provided for presumptive “undiagnosed illness” (UDX) claims.  However, VA’s high rates of denial of these claims led to Congress’ 1998 Gulf War legislation to develop an elegant, science-based, framework for specifying new presumptive conditions for Gulf War veterans.   Unfortunately, VA’s persistent high rates of denial of these presumptive UDX claims led to legislation enacted in 2001 making “medically unexplained chronic multisymptom illnesses” (MUCMIs) presumptive.

Tragically for Gulf War veterans, VA’s high rates of denial of Gulf War veterans’ presumptive claims for “undiagnosed illness” (UDX) and “medically unexplained chronic multisymptom illnesses” (MUCMIs) persist to the present time – along with similarly high rates of denial of Burn Pits Exposure-related claims.

By contrast, Vietnam veterans with presumed exposure to Agent Orange have fared better, with a long list of presumptive conditions now approved.  It is noteworthy that many of these named presumptive conditions required legislation. Indeed, one of the bills now before the Committee would name additional Agent Orange presumptive conditions that VA has failed to make presumptive despite strong evidence and favorable NAS review.

While a framework for Vietnam veterans that presumes exposure to Agent Orange has led to some favorable determinations for new presumptive conditions, Congress has been required to legislate other named presumptive conditions.

 LESSON LEARNED:  6) Named presumptive conditions are critical for toxic exposure veterans.  7) A science-based presumptive determination framework is of significant value. 8) Congress is likely still going to be called upon to act when the science is clear regarding associations of health outcomes with exposures when VA fails to take appropriate action on its own.

 

 

S. 437 – Veterans Burn Pits Exposure Recognition Act of 2021:

 Veterans for Common Sense supports this legislation conceding exposure to four types of airborne hazards and toxic exposures for covered veterans.

We encourage the Committee, in considering this legislation, to expand the covered veterans in this legislation to be as complete as in other current toxic exposure legislation (including airspace and contiguous waters veterans, so as not to create a new class of Blue Water Navy/Air veterans), such as the Presumptive Benefits For War Fighters Exposed To Burn Pits And Other Toxins Act.

We express concern regarding the inclusion of the “causal” terminology in the bill as currently drafted:  “…the Secretary shall request a medical opinion as to any causal link between the disability and a toxic substance, chemical, or hazard set listed in subsection (c)…” [emphasis added].  We are concerned this may be interpreted by VA as parallel to the NAS causation standard of association, an impossibly high bar to meet.

Veterans for Common Sense is grateful to Senator Sullivan and Senator Manchin for their introduction of this legislation, and to the many Senators who have cosponsored it.

Veterans for Common Sense is also deeply grateful to the Disabled American Veterans (DAV) for their leadership efforts in seeking to improve disability claims outcomes for veterans with toxic exposures.

 

S. 444 – AUTO for Veterans Act:

Currently, veterans and service members eligible for the VA automobile allowance and adaptive equipment program as the result of specified service-connected disability or impairment may not receive more than one automobile or other conveyance under the program.  Motor vehicles do not last forever.

S. 444 would allow for eligible veterans and service members to be provided with an additional automobile or other conveyance under this chapter every 10 years.

Accordingly, Veterans for Common Sense strongly supports S. 444, the AUTO for Veterans Act

Veterans for Common Sense is sincerely grateful to Senator Collins, Senator Manchin, Senator Boozman, Senator Blunt, and Senator Hassan for their introduction of the commonsense AUTO for Veterans Act, which is of critical importance to the affected veterans. 

Veterans for Common Sense also commends Paralyzed Veterans of America (PVA) for their instrumental advocacy in supporting this legislation.

 

S. 454 — K2 Veterans Care Act of 2021:

Veterans for Common Sense supports this legislation conceding exposure to certain hazards and toxic exposures for covered veterans.  However, we express concern that some of these, like Depleted Uranium, have previously been the subject of NAS reviews without favorable consideration and “more study is needed”-type recommendations.

Veterans for Common Sense is grateful to Senator Blumenthal, Senator Baldwin, Senator Brown, Senator Menendez, and Senator Feinstein for their introduction of this legislation.

 

S. 565 — Mark Takai Atomic Veterans Healthcare Parity Act of 2021:

Veterans for Common Sense supports efforts to provide full eligibility for VA healthcare eligibility and service-connected disability compensation benefits to all Atomic Veterans.

Veterans for Common Sense also supports efforts, including by the National Association of Atomic Veterans (NAAV), to authorize, create, and award, including posthumously, an Atomic Veteran Service Medal to all Atomic Veterans.

According to the NAAV, Atomic Veterans include all of the following:

“Atomic Veterans were members of the United States Armed Forces who participated in atmospheric and underwater nuclear weapons tests from 16 July 1945 to 30 October 1962.  They also include veterans who were assigned to post test duties, such as “ground zero” nuclear warfare maneuvers & exercises, removing radiation cloud samples from aircraft wing pods, working in close proximity to radiated test animals, de-contamination of aircraft and field test equipment, retrieval and transport of test instruments & devices, and a host of other duty assignments that provided an opportunity for a radiation exposure & contamination event.  Also included are military personnel who were a part of the Occupation Forces assigned to Hiroshima and Nagasaki, Japan soon after the detonation of Atomic-Bombs over those respective cities, and those American prisoners of war (POW’s) who were housed in close proximity to those cities.”

“There is a second group of veterans who may have been involved in radiation exposure events. These include post test events related to nuclear weapon devices detonated underground or in shafts (after 1962) that may have provided a radiation exposure event, or those [whose] duties involved regular use of radiation producing equipment or processes, such as power plant technicians aboard nuclear powered Aircraft Carriers and Submarines, X-ray technicians, and those veterans assigned to the Enewetak Atoll radiation clean-up projects.”[6]

According to a 2019 Stars and Stripes article:

“We were experimental subjects who did not give our advised consent to be experimental subjects,” said [Atomic Veteran Linclon] Grahlfs, 96, a retired sociology professor and author of the book “Voices From Ground Zero: Recollections and Feelings of Nuclear Test Veterans.”

At least 200,000 U.S. troops participated in the tests and cleanup operations during World War II and later in the Pacific Ocean, the Nevada desert, New Mexico and the Atlantic Ocean. They took the human brunt of deadly ionizing radiation that contaminated nearby lands, water and communities.  Even today, the wide-ranging implications of hundreds of tests conducted from the 1940s until the 1960s and cleanup operations that followed in the late 1970s has yet to be fully understood. In all, the U.S. has conducted more than 900 such tests.

Until 1996, the atomic vets were sworn to silence, forced to keep their burdens from their families, their friends and doctors. They had limited records and medical help for their illnesses, and faced a threat of prison if they revealed the secret too soon.[7]

It is unclear whether all Atomic Veterans who are still living know that the Nuclear Radiation and Secrecy Agreements Act, which bound these veterans to secrecy regarding the operations that exposed them to radiation, was repealed.  S. 565 would expand Atomic Veteran-related benefits to veterans who participated in the “Cleanup of Enewetak Atoll during the period beginning on January 1, 1977, and ending on December 31, 1980”.

In keeping with the goals stated above, Veterans for Common Sense strongly supports S. 565, the Mark Takai Atomic Veterans Healthcare Parity Act of 2021

Veterans for Common Sense is grateful to Senator Smith, Senator Tillis, Senator Leahy, Senator Hirono, Senator Klobuchar, Senator King, Senator Warren, Senator Wyden, Senator Van Hollen, Senator Coons, Senator Merkley, Senator Markey, Senator Sinema, Senator Blumenthal, Senator Collins, and Senator Baldwin for their introduction of this legislation.

Veterans for Common Sense commends the tireless and unwavering efforts of the National Association of Atomic Veterans, on behalf of the entire cohort of Atomic Veterans they represent, to achieve justice, healthcare, benefits, and recognition for these long-overlooked veterans.  As our national works to achieve justice for veterans with toxic exposures, it is of great importance that these Atomic Veterans veterans are finally awarded all the measures of justice that they have long sought.

 

S. 657 – A bill to modify the presumption of service connection for veterans who were exposed to herbicide agents while serving in the Armed Forces in Thailand during the Vietnam era, and for other purposes:

Veterans for Common Sense supports this legislation, which would make reduce the burden of proof necessary for certain veterans exposed to Agent Orange.

Veterans for Common Sense thanks Senator Boozman, Senator Tester, Senator Wyden, Senator Gillibrand, Senator Warren, Senator Portman, Senator Hassan, and Senator Braun for their leadership in introducing this legislation.

 

S. 810 – Fair Care for Vietnam Veterans Act of 2021:

The Fair Care for Vietnam Veterans Act would beneficially add two additional conditions to the list of named conditions already approved as “presumptive” for Vietnam War and other veterans presumed to be exposed to Agent Orange.

A 2015 study of the Ranch Hand cohort of Vietnam veterans published in a peer-reviewed Journal of the American Medical Association found a 2.4-fold increased risk for Monoclonal Gammopathy of Undetermined Significance (MGUS) in Ranch Hand veterans versus comparison veterans after adjusting for age, race, and other relevant factors.  The study authors concluded: “Operation Ranch Hand veterans have a significantly increased risk of MGUS, supporting an association between Agent Orange exposure and multiple myeloma.”[8]  According to a press release by the National Academy of Sciences, Engineering, and Medicine (NASEM) for the release of its, “Agent Orange: Update 11 (2018)” report, “MGUS is a clinically silent condition that is a precursor to the cancer multiple myeloma, but only an estimated 1 percent of MGUS cases progress to multiple myeloma each year.”[9]

NASEM’s Update 11 (2018) also upgraded its conclusions regarding the strength of association between exposure to the chemicals of interest and hypertension.  Previously, NASEM had rated hypertension as, “limited/suggestive evidence of an association”, the middle tier of its five-tier rating system for strength of association.  In Update 11 (2018), NASEM upgraded its rating regarding hypertension in Vietnam War veterans to, “sufficient evidence of an association,” the second-highest rating, based on the available published scientific evidence.

This MGUS study was published than half a decade ago and the NASEM report more than two years ago, but VA has yet to take action to make these conditions presumptive for veterans exposed to Agent Orange.  It is notable that Congressional action is once again required to add these presumptive conditions via legislation, conditions which have already been found by science to be of greater prevalence in Vietnam veterans than comparison veterans.

In light of VA’s failure to act on the published scientific evidence regarding the excess prevalence of these conditions among Vietnam War veterans, Veterans for Common Sense strongly supports S. 810, the Fair Care for Vietnam Veterans Act of 2021, to add hypertension and Monoclonal Gammopathy of Undetermined Significance (MGUS) as Agent Orange presumptive conditions.

Veterans for Common Sense is sincerely grateful to Senator Tester, Senator Wyden, Senator Brown, Senator Durbin, Senator Cortez Masto, Senator Menendez, Senator Schumer, Senator Casey, Senator Leahy, Senator Manchin, Senator Blumenthal, Senator Coons, Senator Murray, Senator Klobuchar, Senator Hirono, Senator Smith, and Senator Booker for introducing the Fair Care for Vietnam Veterans Act to add named “presumptive” conditions for VA disability compensation for Vietnam War veterans.

Veterans for Common Sense also commends Vietnam Veterans of America for its enduring leadership in ensuring that health conditions identified as greater in prevalence among Vietnam Veterans continue to be added as named presumptive conditions by whatever means necessary for the Vietnam War veterans VVA so powerfully represents.

S. 927 – Toxic Exposure in the American Military Act (TEAM) Act:

 Veterans for Common Sense strongly supports the expansion of access to VA healthcare that would be granted under this legislation.

Veterans for Common Sense strongly supports the provision of this legislation that would set the bar for NAS strength of association determinations at the “Limited/suggestive evidence of an association” level.

Veterans for Common Sense cautiously supports this bill’s creation of a framework for determining presumptive conditions but given the experience of Gulf War veterans with a similar enacted framework, we are understandably concerned about whether such a process will in actuality result in new, fair, and timely presumptive conditions consistently being added for veterans with those conditions.

Veterans for Common Sense strongly supports the creation of the advisory and oversight body described in this legislation.  While the Research Advisory Committee for Gulf War Illnesses (RAC) created in Gulf War legislation enacted in 1998 did an excellent job in its mission, ultimately, its scope and membership were slashed by VA.  Legislation to properly restore the RAC, which passed the House with unanimous consent, had a new structure and process for naming members that is somewhat similar to that contained in the TEAM Act.

We express concern that language in the current draft of the legislation would not allow for the appropriate and necessary consideration by the NAS of animal studies modeling toxic exposures and health outcomes in those animals.  That language is as follows:  “…that a positive association exists between the exposure of humans to a toxic substance and the occurrence of a disease in humans…”   Such animal studies can be critical for understanding plausible health outcomes in humans, particularly in cases of toxic or hazardous exposures where there is a paucity of human health outcomes data and it would be unethical to conduct experiments exposing humans to such toxins or hazards for scientific evaluation purposes.

Veterans for Common Sense thanks Senator Tillis, Senator Hassan, Senator Moran, Senator. Klobuchar, Senator Blackburn, Senator Baldwin, and Senator Capito for their leadership in introducing this legislation.Veterans for Common Sense commends the TEAM Coalition, led by the Wounded Warrior Project, for its collaborative efforts in developing these legislative proposals.

S. 952 – Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act:

In the strongest possible terms, Veterans for Common Sense supports the list of named presumptive conditions in this legislation, including respiratory conditions, cancers, and the conditions already presumptive for Agent Orange veterans.

Veterans for Common Sense also very strongly supports the comprehensiveness of covered veterans in this legislation, which includes veterans awarded various service medals for their Global War on Terrorism (GWOT service, and extends back to August 1990 and veterans awarded the Southwest Asia Service Medal (SWASM), Armed Forces Expeditionary Medal (AFEM), and other service medals.

As we previously stated publicly, For many veterans with toxic exposures, there has been — for them — a clear timeline connecting their toxic exposures during their military deployments to the debilitating health outcomes that followed them home. Far too many veterans who were exposed to open burn pits and a veritable toxic soup have developed terrible respiratory conditions, Parkinson’s and other diseases, and cancers, including the brain cancer that has taken so many of their lives.  This critically important legislation will provide the missing link to help these veterans.  Indeed, this is the only current, major toxic exposure legislation to actually name presumptive conditions for VA disability claims rather than lay out a bureaucratic process that relies on trusting VA to do the right thing — the same VA that currently denies Gulf War and Burn Pits-related claims at 80 percent denial rates.  In this year of the 30th anniversary of the beginning of the Gulf War (Operation Desert Storm), we are deeply grateful to Senator Gillibrand and the many powerful cosponsors for ensuring this legislation will help so many veterans who served, including Gulf War, other pre-9/11, and post-9/11 veterans alike.”

Veterans for Common Sense profoundly thanks Senators Gillibrand and Rubio for their leadership in introducing this legislation in the Senate, and for Representatives Ruiz and Fitzpatrick for introducing a companion bill in the House.  Veterans for Common Sense wholeheartedly commends Burn Pits 360, Jon Stewart, John Feal, and the many supportive organizations involved for their efforts on this crucial legislation.

 

 S. 1039 – Improving Benefits for Gulf War Veterans Act:

Veterans for Common Sense strongly supports this bills’ provision to make permanent the period for filing Gulf War related claims.  VA has provided multiple five-year extensions to date, and we understand is currently working on another.  However, medical research has consistently shown that the health of veterans with Gulf War Illness is not improving and is likely worsening.  After 30 years, there is little justification that any more study is needed as to whether Gulf War veterans are ill.

Veterans for Common Sense strongly supports the provision in this legislation that would extend eligibility to VA benefits and healthcare currently available to most Gulf War veterans to also include veterans with qualifying service in Afghanistan, Egypt, Israel, Jordan, Syria, and Turkey.  Veterans for Common Sense published an analytical issue paper in 2017 which may be of interest to the Committee regarding Gulf War veterans issued the Southwest Asia Service Medal (SWASM) but not included as Gulf War veterans by VA for healthcare and benefits purposes.[10]  It remains unclear to us why these Gulf War veterans awarded the SWASM for their Gulf War service were not initially included by VA in 1994 as Gulf War veterans.  We have long sought a remedy for these veterans and are grateful for its critically important inclusion here.

We note that as currently drafted, this legislation would not also grant coverage to veterans with service in the airspace above or the contiguous waters of these added six countries.  This is the result of the technical interplay between the wording added to 38 USC 1117 by this legislation and 38 CFR 3.317, which includes the current geographic definition for covered veterans.  We would be happy to work with the Committee on this issue.

Veterans for Common Sense strongly supports the reduction in threshold for eligibility provided by this bill.

Veterans for Common Sense strongly supports the bill’s requirement for a single Disability Benefits Questionnaire (DBQ) for Gulf War Illness symptoms and issues.  Since the 1994 enactment of legislation making “undiagnosed illnesses” (UDX) presumptive for VA compensation claims, VA’s high denial rates of these claims have persisted.  VA’s denials of presumptive “medically unexplained chronic multisymptom illness” (MUCMI) claims remain a serious issue for the denied veterans.  A 2017 GAO report and related House Veterans’ Affairs Committee hearing at which we testified showed a roughly 90 percent denial rate of UDX claims and a denial rate nearly as high for MUCMI claims.[11]  VA is no longer publicizing benefits utilization data, including claims grant and denial rates, so there is no reason to believe there have been substantial improvements.

Given the persistent high rates of denial of GWI claims, Veterans for Common Sense has recommended the creation of a symptom-based schedule of ratings for symptoms-based disabilities like Gulf War Illness. We have suggested that it be modeled at least loosely upon the current schedule of ratings for traumatic brain injury (TBI), with “buckets” of types of symptoms and a points-based system for rating disability.  Such a schema could also be applied to veterans with toxic exposure-related symptoms that do not current (or do not yet) meet diagnostic criteria for existing diseases.  Again, we would be happy to work with the Committee in this regard.

Veterans for Common Sense strongly supports the bill’s provisions regarding training for VA personnel.  We recommend that the bill’s language be expanded to cover VBA benefits personnel in addition to the VA health care personnel currently specified in the bill.

In keeping with the goals and recommendations stated above, Veterans for Common Sense strongly supports S. 103, the Improving Benefits for Gulf War Veterans Act.  Veterans for Common Sense is deeply grateful to Senator Menendez for the introduction of this legislation.  Veterans for Common Sense is also deeply grateful to the Veterans of Foreign Wars (VFW) for the strong support of this legislation.


FOOTNOTES:

[1] House Veterans’ Affairs Committee, Subcommittee on Oversight and Investigations and Subcommittee on Disability Assistance and Memorial Affairs, March 15, 2016, “Twenty-Five Years After The Persian Gulf War: An Assessment Of VA’s Disability Claims Process With Respect To Gulf War Illness”: https://archives-veterans.house.gov/submission-record/aanthony-hardie-gulf-war-veteran-and-director-veterans-common-sense

[2] H.HRNG 37-476, House Committee on Veterans’ Affairs, Subcommittee on Health, “Gulf War Exposures”, July 26, 2007: https://www.govinfo.gov/content/pkg/CHRG-110hhrg37476/html/CHRG-110hhrg37476.htm

[3] http://veteransforcommonsense.org/wp-content/uploads/2020/02/Conditions-Associated-with-Gulf-War-exposures-consolidated-NAS-IOM-listing.pdf

[4] Persian Gulf War Veterans Act of 1998 [Title XVI, P.L. 105-277, “Omnibus Consolidated and Emergency Supplemental Appropriations Act, 1999”], Sec. 1603(d) [“Initial Consideration of Specific Agents”].

[5] Persian Gulf War Veterans Act of 1998 [Title XVI, P.L. 105-277, “Omnibus Consolidated and Emergency Supplemental Appropriations Act, 1999”], Sec. 1603(d) [“Initial Consideration of Specific Agents”].

[6] NAAV website:  https://www.naav.com

[7] Stars and Stripes, “Conspiracy of silence: Veterans exposed to atomic tests wage final fight,” by Claudia Grisales, June 16, 2019: https://www.stripes.com/news/special-reports/conspiracy-of-silence-veterans-exposed-to-atomic-tests-wage-final-fight-1.585789

[8] Ola Landgren, Youn K Shim, Joel Michalek, Rene Costello, Debra Burton, Norma Ketchum, Katherine R Calvo, Neil Caporaso, Elizabeth Raveche, Dan Middleton, Gerald Marti, Robert F Vogt Jr, JAMA Oncol, “Agent Orange Exposure and Monoclonal Gammopathy of Undetermined Significance: An Operation Ranch Hand Veteran Cohort Study,” 2015 Nov;1(8):1061-8.  https://doi.org/10.1001/jamaoncol.2015.2938.

[9] https://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25137.  See: National Academies of Sciences, Engineering, and Medicine. 2018. Veterans and Agent Orange: Update 11 (2018). Washington, DC: The National Academies Press. https://doi.org/10.17226/25137.

[10] http://veteransforcommonsense.org/wp-content/uploads/2019/05/ISSUE-Resolving-Differences-in-Definitions-of-Persian-Gulf-War-Veteran-.pdf

[11] https://docs.house.gov/Committee/Calendar/ByEvent.aspx?EventID=106223


 

Posted in Burn Pits, Gulf War Updates, Legislative News, Research, Toxic Wounds, VCS Congressional Testimony, VCS In The News, Veterans for Common Sense News | Comments Off on Veterans for Common Sense provides Testimony for Senate Hearing on Pending Legislation

25 Organizations Urge Congress to Renew Funding for the Treatment-focused Gulf War Illness Research Program

(Washington – April 27, 2021) – Today, 25 organizations urged Congress to renew funding for the treatment-focused Gulf War Illness Research Program.  The organizations included most of the leading veterans service organizations along with military service organizations and toxic exposure advocacy organizations.

“Veterans with Gulf War Illness are in need of evidence-based treatments to improve their health and lives,” said Anthony Hardie, National Chair and Director of Veterans for Common Sense.

Research funded by the GWIRP continues to make advances, as shown by recent research publications, in unraveling Gulf War Illness’s complexities and identifying and testing potentially effective treatments.

“The progress being made because of this unique treatment development program is highly encouraging,” said Hardie.

The letter was addressed to House Defense Appropriations Subcommittee Chair Rep. Betty McCollum (D-Minn.) and Ranking Member Rep. Ken Calvert (R-Calif.).  It called for renewed funding for the Gulf War Illness Research Program (GWIRP) within the Department of Defense Congressionally Directed Medical Research Program (CDMRP).

The letter supports the efforts of nearly 80 Members of the U.S. House of Representatives to renew the program’s funding.  The House effort is being led by Del. Gregorio Kilili Camacho Sablan (D-N. Marianas), who serves on the House Veterans’ Affairs Committee, and Rep. Jack Bergman (R-Mich.), who serves as the Ranking Member of the House Veterans’ Affairs Subcommittee on Health.  That effort by House Members is expected to wrap up this week.

A similar effort in the U.S. Senate is being led by U.S. Senator Tammy Baldwin (D-Wis.).

As a Congressionally directed program, federal funding for the GWIRP must be renewed by Congress each year.

The full text of the letter (PDF), which includes a list of — and links — to the supporting organizations, follows below:

 


April 27, 2021

The Honorable Betty McCollum
Subcommittee on Defense  Appropriations
U.S. House of Representatives
H-406 The Capitol
Washington, DC  20515

The Honorable Ken Calvert
Subcommittee on Defense  Appropriations
U.S. House of Representatives
1036 Longworth House Office Building
Washington, DC  20515

Dear Chair McCollum and Ranking Member Calvert,

On behalf of the thousands of veterans and their interests represented by our organizations, we would like to offer our support for your efforts in securing the necessary resources to support the continued work by the treatment-focused Gulf War Illness Research Program (GWIRP), part of the Congressionally Directed Medical Research Program (CDMRP) within the Department of Defense (DoD). We thank you for your strong past support for the GWIRP, including providing the program $22 million in Fiscal Year 2021 (FY21).

Successive federally funded reviews by the National Academy of Sciences (NAS) [1] and federal research committees[2]of published, peer-reviewed studies have consistently concluded that Gulf War Illness (GWI) affects approximately 25-32% of the veterans of the 1990-91 Gulf War.[3] “GWI is characterized by multiple, diverse symptoms that typically include chronic headache, widespread pain, cognitive difficulties, debilitating fatigue, gastrointestinal problems, respiratory symptoms, sleep problems, and other abnormalities that could not be explained by established medical diagnoses or standard laboratory tests.”3 “Scientific research… supports and further substantiates… that Gulf War illness… resulted from hazardous exposures in the Gulf War theater.”2 (p.1)

By congressional design, the GWIRP is a unique, treatment-focused research funding program.  Its singular aim: “improved health and lives of veterans who have Gulf War Illness,”3 by finding and funding the best Gulf War Illness research that: 1) “expeditiously identifies effective treatments and accelerates their clinical application,” 2) “improves definition and diagnosis,” and 3) “results in better understanding of pathobiology and symptoms of disease.”3  Several CDMRP features set it apart from other federal research programs: “funding high impact, high risk and high gain projects that other agencies may not venture to fund”[4] on a highly competitive, extramural basis that includes researchers and multidisciplinary research teams from government agencies, academia, and/or the private sector; multiple tiers of peer review in funding decision-making; comprehensive inclusion of consumers (patients with the disease being studied).

In its landmark update on GWI, the NAS called for the federal government, “to speed the development of effective treatments, cures, and, it is hoped, preventions.”1 The GWIRP’s mission remains focused on doing exactly that.  While the COVID-19 pandemic adversely impacted much of the world, including research study progress, even still the GWIRP produced a number of key results in the last year. Among the highlights was co-hosting the first-ever Gulf War Illness State of the Science Conference in August 2020, intended to foster scientific progress.  Held entirely online due to the pandemic, it included 67 presentations of GWIRP-funded GWI research, 42 presentations on GWI and other health conditions by VA, a Gulf War veteran panel, and hundreds of attendees who communicated and collaborated in real-time.[5]

Several of the GWIRP-funded researchers who completed their studies during the last year and had their results published in peer-reviewed journals focused importantly on the neuroinflammation and impaired bioenergetics issues understood to underlie GWI.  Others found evidence for the role of other brain systems and the gut-brain axis.  Each new finding further unraveled GWI’s complexities, including identifying potential biomarkers and treatment targets. Several treatment pilot studies showed promise for larger-scale evaluation: a glutamate-reducing dietary intervention; nicotinamide riboside; and, three of nine botanical compounds tested including Curcumin, Resveratrol, and Pycnogenol.  The GWIRP-funded Gulf War Illness Clinical Trials and Interventions Consortium (GWICTIC) is now recruiting for multiple interrelated clinical trials.  Additionally, a large-scale, GWIRP-funded clinical trial of CoQ10 is now underway, aimed at confirming and validating the form of CoQ10 found in a GWIRP-funded pilot study to be efficacious in reducing several GWI symptoms.

Meanwhile, a GWIRP-funded longitudinal study of the Ft. Devens Cohort of Gulf War veterans further linked Gulf War toxic exposures to GWI symptoms and provided further evidence that GWI has worsened over time.  Among 1990-91 Gulf War troops, seven percent were women; another GWIRP-funded study showed they continue to report rates of multiple symptoms at double the rate of their female non-deployed counterparts, further demonstrating that GWI remains a serious and unrelenting health issue.

The GWIRP remains the only federal program exclusively focused on developing treatments for this debilitating, chronic condition.  Given its unique continuing value, we respectfully request your support in providing adequate Fiscal Year 2022 funding for the GWIRP to continue its vital and effective work and to support its progress into larger-scale clinical trials.  It is also critical to the GWIRP’s success and accountability that it remain a focused, stand-alone program within the CDMRP and not be combined within broader programs with multiple topic areas.

Thank you for your consideration of our request.  We deeply appreciate your support.

Sincerely,

Blinded Veterans Association
Burn Pits 360
California Communities Against Toxics
Cease Fire Campaign
DAV
Fleet Reserve Association
Iraq and Afghanistan Veterans of America
Jewish War Veterans of the USA
Military Order of the Purple Heart
Military-Veterans Advocacy
National Veterans Legal Services Program
National Vietnam & Gulf War Veterans Coalition
Paralyzed Veterans of America
Reserve Organization of America (ROA)
Sergeant Sullivan Circle
Service Women’s Action Network (SWAN)
The Quinism Foundation
Tragedy Assistance Program for Survivors
United Soldiers and Sailors of America
Veteran Warriors
Veterans and Military Families for Progress
Veterans for Common Sense
Veterans of Foreign Wars
VetsFirst
Vietnam Veterans of America

—–

[1] National Academy of Sciences, “Gulf War and Health, Volume 8: Update of Health Effects of Serving in the Gulf War,” 2010.

[2] Research Advisory Committee on Gulf War Veterans’ Illnesses, U.S. Department of Veterans Affairs, “Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013,” 2014.

[3] DoD CDMRP GWIRP webpage: https://cdmrp.army.mil/GWIRP

[4] DoD CDMRP webpage: https://cdmrp.army.mil/aboutus

[5] CDMRP, “Joint VA/DoD Gulf War Illness State of the Science Conference Draws Hundreds of Researchers and Veterans: Online Event Coincides with 30-Year Anniversary of Operation Desert Shield”: https://cdmrp.army.mil/gwirp/research_highlights/20Goldman_highlight


 

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Veterans for Common Sense Strongly Supports the VA VACCINE Act

LATEST UPDATE (03/19/2021): This legislation has now passed Congress and is enroute to the President for swift signing into law, after being further expanded and renamed as the Strengthening and Amplifying Vaccination Efforts to Locally Immunize all Veterans and Every Spouse (SAVE LIVES) Act.

  • PRESS RELEASE: WITH SENATE AMENDMENT, LEGISLATION HEADS TO THE PRESIDENT’S DESK.  LINK
  • PRESS RELEASE: Bill to Expand Vaccine Access for Veterans & Their Spouses Goes to President to be Signed Into Law.  LINK
  • PRESS RELEASE: Sen. Moran’s Bill to Expand Vaccine Access for Veterans, Spouses & Their Families Passes the Senate. LINK
  • PRESS RELEASE:  CHAIRMAN TAKANO & RANKING MEMBER BOST’S VA VACCINE ACT PASSES THE HOUSE: Urges swift Senate action to ensure veterans won’t be turned away from a COVID-19 vaccine.  LINK

***

(Washington – March 9, 2021)  Veterans for Common Sense, a national veterans service organization, today issued the following letter to House Veterans’ Affairs Committee leadership in strong support of the VA VACCINE Act (H.R. 1276).

The full text of the letter is below.

The bipartisan legislation was introduced by Chairman Mark Takano (D-CA) and Ranking Member Mike Bost (R-IL) and supported by numerous cosponsors and veterans service organizations (VSO’s).


2021-03-09 VCS Support for VA VACCINE Act [PDF]

March 9, 2021

The Honorable Mark Takano                                       The Honorable Mike Bost
Committee on Veterans Affairs                                   Committee on Veterans Affairs
U.S. House of Representatives                                   U.S. House of Representatives
B234 Longworth House Office Building                        3460 O’Neill House Office Building
Washington, DC  20515                                           Washington, DC  20515

SUBJECT:  Veterans for Common Sense Supports the VA VACCINE Act of 2021

Dear Chairman Takano and Ranking Member Bost,

We write to express the strong support of Veterans for Common Sense (VCS) for the VA VACCINE Act of 2021.  We deeply appreciate your leadership in authoring this bipartisan Veterans’ Affairs Committee bill to further expand access to the COVID vaccination for the millions of our nation’s veterans who are not currently enrolled or eligible to enroll in Department of Veterans Affairs (VA) healthcare.

Thank you for ensuring that this legislation would extend VA’s ability to provide these crucially important vaccinations to all our nation’s veterans.  As we know, only about nine million of our nation’s 19.5 million veterans are currently enrolled in VA healthcare.  This legislation is all the more important given the fact that millions of veterans are not eligible to enroll in VA healthcare due to income limitations or other enrollment factors.

Additionally, while implementing this bill, it would be an excellent opportunity for VA to enhance its outreach and increase enrollment of many more veterans in need, including minority and under-represented veteran subpopulations that may currently be under-enrolled.  It would also be important for VA to contact and include veterans discharged with “bad paper” under conditions other than dishonorable, in accordance with 38 U.S.C. 101(2).

The bill’s current inclusion of veterans’ caregivers is also of critical importance.  We continue to look forward to implementation of the planned expansion of the VA Caregiver Program to include the caregivers of Gulf War and other veterans who served between May 8, 1975 and September 11, 2001.  Meanwhile, this bill importantly also includes veterans’ caregivers who are enrolled in VA’s Program of General Caregiver Support Services – though outreach is of great importance there, too, for caregivers not currently enrolled.

We are in very strong support of this legislation and are grateful for your leadership efforts.  The expanded coverage provided by the VA VACCINE Act is likely to be an important component in helping to resolve this international emergency.

Sincerely,

/s/

Anthony Hardie
National Chair & Director
Veterans for Common Sense


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Statement on the Peaceful Transfer of Power

January 19, 2021

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38 Organizations, including Veterans for Common Sense, release the following statement about the inauguration of the 46th President of the United States:

Statement on the Peaceful Transfer of Power

Following the failed insurrection attempt of January 6, 2021, the undersigned organizations, who serve members of our military, veterans, caregivers, and their families, join in condemning this violent attack on our country, our democracy, and our Constitution.  We affirm our commitment to the US Constitution, our free and fair elections, and the tradition of a peaceful transfer of power. Visit arturoherrera for more updated information.

We endorse the statement made by the Joint Chiefs of Staff to the joint force, which is made up of about 1.3 million active-duty service members and more than 811,000 National Guardsmen and reservists,

“The violent riot in Washington, D.C. on January 6, 2021 was a direct assault on the U.S. Congress, the Capitol building, and our Constitutional process. We witnessed actions inside the Capitol building that were inconsistent with the rule of law. The rights of freedom of speech and assembly do not give anyone the right to resort to violence, sedition and insurrection.”

Our veterans and men and women in uniform each take an oath to uphold and defend the US Constitution, which provides for the peaceful transfer of power after an election – as confirmed by the States and courts, and certified by the US Congress.  Members of the National Guard are now activated to protect the results of that election.  We call on our fellow Americans to respect the electoral process, as well as the men and women of the National Guard who will be fulfilling their oaths to defend the Constitution against all enemies, foreign and domestic.  There must be no further violence.  We, the undersigned, join in opposition to any effort to overthrow our democracy or disrupt the peaceful transfer of power.

We also call for accountability for those responsible for the seditious acts leading up to and including January 6, 2021. We call upon veterans, members of the military, and each of us who have sworn an oath to uphold the Constitution to stand firmly in support of democracy and to recommit to the peaceful transfer of power. We ask our political leaders, who have sworn that very same oath, to do the same.

Signed,

Posted in VCS In The News, Veterans for Common Sense News | Comments Off on Statement on the Peaceful Transfer of Power

Veterans for Common Sense Provides Testimony for Congressional Hearing on Toxic Exposure Presumptive Conditions

(Washington – December 9, 2020) – Veterans for Common Sense provided invited written testimony for today’s Congressional hearing on the determination process for presumptive conditions for veterans’ disability claims relative to toxic exposures.

The Congressional hearing, held by the  Subcommittee on Disability Assistance and Memorial Affairs of the U.S. House of Representatives Committee on Veterans’ Affairs, was entitled, “The Toxic World of Presumptive Service Connection Determinations: Why Should Our Veterans Wait?”  [Video]  [Written statements]

The full text of VCS’s written testimony is below, or available in PDF download at: Statement for the Record – December 9, 2020 Toxic Exposure Presumptive process – HVAC-DAMA

 

*****

STATEMENT FOR THE RECORD
OF
ANTHONY HARDIE, NATIONAL CHAIR & DIRECTOR, VETERANS FOR COMMON SENSE
FOR A DECEMBER 9, 2020 HEARING
OF THE
HOUSE COMMITTEE ON VETERANS’ AFFAIRS,
SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS:
“THE TOXIC WORLD OF PRESUMPTIVE SERVICE CONNECTION DETERMINATIONS: WHY SHOULD OUR VETERANS WAIT?”

Chairwoman Luria, Ranking Member Bost, and Members of the Subcommittee, Veterans for Common Sense (VCS) thanks you for holding this critically important hearing on presumptive service connection determinations relative to toxic exposures.  In this statement, we will keep our comments focused primarily on the Gulf War cohort.

VCS is a non-profit national advocacy organization deeply involved in this issue for nearly two decades, and all of our leaders are veterans who deployed to Southwest Asia during the first year of the Persian Gulf War (see 38 USC 101(33) and 38 CFR 3.317).

Learning Past Lessons

 We recognize and respect that the intent of this hearing is to focus on understanding and providing desperately needed Congressional oversight into the process whereby VA makes its determinations for new presumptive conditions for VA service connection.  However, before addressing that core focus, we believe it is of direct relevance to share a brief discussion on two sets of presumptive conditions related to toxic exposures, and how those have played out in actuality following their creation.  The point we would like to make is that addressing the process of creating new presumptive conditions is critical, and it is at least equally important to address significant, decades-old VA failures to favorably adjudicate certain toxic exposure-related presumptive conditions for which VA already has clear authority to grant. Visit korucaredoula to know detailed information.

VA must first fix the current process.  Otherwise, VA will repeat its mistakes made for the Gulf War cohort and the presumptive legislation enacted in 1994, 1998, and 2001.

VCS has provided testimony to this Subcommittee on a number of occasions over the years describing VA’s badly broken claims approval process for Gulf War veterans.  One of those occasions was July 13, 2017, when this Subcommittee held a hearing entitled, “Examining VA’s Processing of Gulf War Illness Claims.”  The hearing coincided with a July 2017 release of a fact-finding Government Accountability Office (GAO report initiated at our request, entitled, “Gulf War Illness: Improvements Needed for VA to Better Understand, Process, and Communicate Decisions on Claims”.

VCS provided invited-witness testimony during that hearing, along with a longer statement for the record.  Our testimony and statement discussed numerous deeply concerning and seemingly intractable issues relative to Gulf War Illness (GWI) claims.  As defined in that GAO report, “GWI claims” are a combination of Gulf War-related undiagnosed illness (UDX) and chronic multi-symptom illness (CMI) presumptive toxic claims.  That GAO report added emphasis and gravitas to what VCS and predecessor organizations had long been exclaiming:  VA continues to improperly deny the vast majority of Gulf War veterans’ GWI claims, despite repeated legislative, regulatory, policy, and training corrective efforts.

Among the serious issues we discussed in that testimony:

  • VA’s denial of all GWI claims at a rate greater than 80 percent.
  • VA’s denial of UDX claims at a 90 percent rate.
  • VA’s denial rates worsening over time.
  • These Gulf War claims taking 50% longer than other claims, meaning veterans who are the worst off suffer the longest.

While Congress and GAO have provided needed oversight, VCS is truly disheartened that we have seen no evidence of improvement in these rates and trends.

VCS also emphasized during that hearing that “undiagnosed illness” (UDX) as a presumptive mechanism for granting symptom-based claims for ill Gulf War veterans had clearly failed, notwithstanding the good intentions when the UDX presumptive was created by Congress in 1994.  VCS called on Congress to, “work in a bipartisan manner with the President to enact legislation to once and for all fix Gulf War Illness claims and the many other Gulf War issues we raise in this and previous written testimony.”

Following that hearing, we were pleased to have a highly constructive meeting with then-Secretary David Shulkin, where we were joined by Vietnam Veterans of America in proposing what we believe to be a viable path forward to remedy these longstanding problems.  Part of that path included using as a model VA’s “Schedule for Rating Disabilities; Evaluation of Residuals of Traumatic Brain Injury (TBI),” – another symptom-based condition.[1]

Regrettably, despite Dr. Shulkin’s highly favorable response and an agreement to move forward together, he was fired before being able to accomplish our shared goals.  Our efforts thereafter to continue discussions with VA on these issues were met with only silence.

 

The Presumptive Adjudication Process

The complex process for considering potential new presumptive conditions for Gulf War veterans has been a contorted, painstaking one that has yielded little of benefit to ill and suffering Gulf War veterans.

 Historically, VA has relied on a review of available scientific evidence before making a determination regarding creating new presumptive conditions for Gulf War veterans.  The National Academy of Sciences, Engineering, and Medicine (NASEM) has conducted and published numerous VA-contracted literature reviews of Gulf War peer-reviewed published research findings.  Most of these reports have been released as part of the “Gulf War & Health” series.  Most of these reports include conclusions regarding the strength of association between deployment to the Gulf War or Gulf War exposures and particular health outcomes.

As important background information, the NAS (and the Institute of Medicine before it) has used five strength-of-association categories.  They are as follows, drawn directly from the Gulf War & Health series volumes:

  • Sufficient evidence of a causal relationship, that is, the evidence is sufficient to conclude that between being deployed to the Gulf War causes a health outcome.
  • Sufficient evidence of an association; that is, a positive association has been observed between deployment to the Gulf War and a health outcome in humans.
  • Limited/suggestive evidence of an association; that is, some evidence of an association between deployment to the Gulf War and a health outcome in humans exists.
  • Inadequate/insufficient evidence to determine whether an association exists; that is, available studies are of insufficient quality, validity, consistency or statistical power to permit a conclusion regarding the presence or absence of an association.
  • Limited/suggestive evidence of no association; that is, several adequate studies are consistent in not showing an association between deployment and a health outcome.

VA created a fatal flaw that prevents a reasonable review of peer-reviewed and published studies.  VA mandated that NASEM panels be prevented, through their VA-contracted charter, from including animal studies when making these strength of association conclusions.  Excluding animal studies prevented NASEM panels from incorporating and weighing the strength of association of all of the relevant scientific information about these toxins.  Additionally, many if not most smaller pilot studies have also been similarly excluded.  Not surprisingly, therefore, the Gulf War and Health series has not led to new presumptive conditions related to Gulf War Illness* for the purpose of VA service-connected disability claims.

(*Note:  In 2010, VA announced — based on the 2006 recommendations in Gulf War and Health, Volume 5 — that nine rare endemic infectious diseases would be presumptive for veterans with qualifying Southwest Asia or Afghanistan service.)

A complete list of all conditions considered by NAS (formerly the Institute of Medicine (IOM)) in the Gulf War & Healthseries, comprising over 400 exposures, has been compiled by Veterans for Common Sense.  Along with their NAS categories of association, this spreadsheet analysis is entitled, Conditions Associated with Gulf War exposures – consolidated NAS-IOM listing.  It is available on the Veterans for Common Sense webpage[2] and is provided as an attachment to this statement.

In short, the VA-contracted presumptive determination process with NAS has almost entirely failed Gulf War veterans.  Most importantly, beyond the endemic infectious disease presumptive determinations that have been relevant to relatively few veterans, the process has led to no new presumptive conditions for Gulf War veterans, including:

  • No Presumptive Cancers, such as the brain cancers that have taken the lives of so many Gulf War veterans.
  • No Presumptive Neurologic or neurodegenerative conditions (with the exception of ALS, which was granted as a presumptive to any veterans, not just Gulf War veterans), such as the neuropathies and myriad neurologic and neurodegenerative conditions and symptom-sets reported in the Gulf War veteran communities, and by their survivors.
  • No Presumptive Respiratory conditions, despite heavy exposures to burning Kuwaiti oil well fires and widely reported and heavily claimed (and denied) pulmonary and sinus conditions.
  • No Presumptive structural gastrointestinal or digestive conditions, including the widely reported (and usually denied) gastro-esophageal reflux disease (GERD).
  • No Presumptive Sleep disorders, including widely reported (and usually denied) sleep apnea, insomnia, and other diagnosed sleep disorders.
  • No Presumptive conditions related to other major internal organs: liver, kidneys, bladder, etc.

Meanwhile, decades of medical research have shown that as many as one-third of the nearly 697,000 veterans of the 1991 Gulf War remain ill and suffering with chronic multi-symptom illness – what we typically call Gulf War Illness.  It is therefore unfathomable that there have been no presumptive conditions

Meanwhile, the VA Secretary has broad legislative authority (see 38 U.S.C. 1118) to favorably determine new presumptive conditions for Gulf War veterans’ claims.  However, to our recollection, no VA Secretary has ever actually made such a determination for Gulf War health conditions beyond the largely inconsequential exceptions mentioned herein and in our prior testimony (rare endemic infectious diseases that have affected few individuals; fine-tuning of certain existing presumptive chronic multi-symptom illness; ALS for all veterans not exclusive to those who served in the Gulf War).

Indeed, a process led by a Gulf War veteran advocate who is now a Toxic Wounds Consultant with Vietnam Veterans of America sought for successive VA Secretaries to use this presumptive determination authority to favorably adjudicate a new presumptive condition for service connection, brain cancer, which has fatally afflicted many Gulf War veterans.  These sincere efforts were stonewalled by the Office of Management and Budget (OMB) in two successive Administrations of differing political parties.  The end result is that afflicted veterans and their survivors remain shut out from needed healthcare and benefits that VA should have provided where and when they are needed.

Furthermore, there has been little consistency in the process whereby VA has initiated NAS/IOM reviews, some of which have been initiated only following public pressure.  Meanwhile, after an NAS/IOM committee has concluded its work and publicly released its final report, many months – or even years – go by before VA makes determinations based on the findings.

These proposed determinations have typically been published in the Federal Register.  Typically, VA request public comments, which VA has then acknowledged, and then proceeded to reject virtually all recommendations made by veterans service and other organizations, veterans, and other stakeholders.

The looming question is: Why has this VA-NAS/IOM process not led to new presumptive conditions for VA service connection for Gulf War veterans?

Is the failure rooted in VA’s population (epidemiological) studies, which, if conducted right, would show statistical data exposing any excess prevalence of various health conditions among the Gulf War cohort or logical subcohorts?  Certainly, that is one aspect, as exposed in a March 2013 House Veterans’ Affairs Committee hearing at which I also testified.  As reported by USA Today (“Researcher says officials covered up vets’ health data”)[3] regarding the hearing:

Department of Veterans Affairs officials purposely manipulate or hide data that would support the claims of veterans from Iraq and Afghanistan to prevent paying costly benefits, a former VA researcher told a House subcommittee Wednesday.

“If the studies produce results that do not support the office of public health’s unwritten policy, they do not release them,” said Steven Coughlin, a former epidemiologist in the VA’s public health department.  “This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War,” Coughlin said. “On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible.”

Or is it failure inherent in the VA-NAS/IOM process?

Certainly, it is that, also.  However, rather than restate, the following section is drawn verbatim from a previously submitted Statement for the Record.  The Statement was co-authored by James H. Binns, longtime former Chair of the RAC-GWVI; Dr. Roberta White, past scientific director of the RAC; Paul Sullivan, VCS National Vice Chair who helped author the first RAC charter following successful enactment of the 1998 legislation directing its creation; and myself.  The select portions from that Statement are as follows:[4]

“Collectively in our individual roles, we led the passage of the 1998 legislation creating the congressionally-mandated Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI); authored its charter; served as its chair, scientific director, and advocates for affected veterans; co-authored its groundbreaking reports.  From these deeply engaged leadership perspectives, we feel an obligation to point out near-certain outcomes should the bill proceed without ensuring that future reviews directed under the legislation also include both human and animal studies of toxic exposures.

This gravely serious problem has been made apparent by the many reports released by the National Academies in these regards, including the recent report[5] and related news release of a National Academy of Medicine (NAM) committee on respiratory health effects among veterans who served in Southwest Asia. “The current uncertainty should not be interpreted as meaning that there is no association — rather, the issue is that the available data are of insufficient quality to draw definitive conclusions,” said the committee chair in a news release about the report.[6]  Similarly, a 2011 National Academies (Institute of Medicine (IOM)) committee concluded there is, “[i]nsufficient data on service members’ exposures to emissions from open-air burn pits,” and that this, “is one of the reasons why it is not possible to say whether these emissions could cause long-term health effects.”  However, “the committee pointed out shortcomings in research and gaps in evidence that prevented them from drawing firm conclusions…”.[7]

“The major problem with this recent NAM report on veterans’ respiratory health issues, and with the related 2011 IOM burn pits report,[8] and with the entire compendium of NAM/IOM reports related to burn pits exposure and Gulf War exposures and health is not that there are no good human studies – though that is indeed a true statement.  Instead, the real problem is that VA has failed to follow the law by failing to require that NAS reports consider scientific evidence in humans and animals.

“Congress in 1998 established the standard for finding an association between toxic exposures and illness in veterans of the 1991 Gulf War.  Congress directed that VA and the National Academy of Sciences consider the exposure of humans and animals to specified toxins, the occurrence of illness in both humans and animals, and the associations between occurrence of illness in both humans and animals [38 U.S.C. 1118].[9]  Congress repetitively specified this explicit directive of both human and animal studies because its Members and staff knew that most studies of toxic substances are necessarily done in animals.

“However, VA (and, by consequence, the VA-contracted NAM/IOM) did just the opposite, using a standard that limited consideration of associations between illness and exposure to solely human studies This deeply corrupted standard has been used in all subsequent NAS reports on Gulf War exposures and burn pits, and in effect ensures no association can ever be found. 

“If the VA-contracted NAM were to follow the law requiring equal consideration of human and animalstudies of toxic exposure, they would reach dramatically different conclusions about the serious and lasting effects of these toxins on veterans’ health.  The recent NAM respiratory health committee noted that the reason for its negative conclusion is that there are no good human studies: “The current uncertainty should not be interpreted as meaning that there is no association — rather, the issue is that the available data are of insufficient quality to draw definitive conclusions.”[10]

“Even more dramatically, the 2011 IOM burn pits report found: “Chemicals in all three major classes of chemicals detected [from burn pits at Joint Base Balad, Iraq] … have been associated with long-term health effects.  A wide array of health effects have been observed in humans and animals after exposure to the specific pollutants detected ….  The health-effects data on the other pollutants detected include: neurological effects, liver toxicity and reduced liver function, cancer, respiratory toxicity and morbidity, kidney toxicity and reduced kidney function, blood effects, cardiovascular toxicity and morbidity, reproductive and developmental toxicity.”[11] However, the report’s conclusion considered only the sharply limited human studies, excluding this evidence and finding no association relevant to exposed veterans’ health.

“In short, the problem is not the science.  The problem is the corruption of science through the application of impossible and unlawful standards.  The result is a large stack of expensive NAM and IOM reports that do little to nothing to improve the health and lives of veterans suffering the ill effects of toxic exposures from their exposures to burn pits and during the Gulf War.

“Past performance seems likely to be a predictor of future performance.  Unless animal studies of toxic exposure are explicitly directed in all legislation that directs NAM studies related to toxic exposures and veterans’ health, it is unclear how future NAM considerations of strength-of-association determinations will result in any outcomes more favorable to veterans than NAM to date.  And, unless the use of the corrupted standard described above is changed, future NAM reports will be similarly unhelpful to the veterans suffering these adverse health outcomes resulting from their military toxic exposures.”

Our recommendations included the following:[12]

  1. “Ensure animal studies are included in all toxic exposure legislation inclusion that references research. It is worth noting that in most cases, the animal studies of relevance have already been conducted, and such inclusion would not explicitly authorize nor require additional studies; indeed, these NAM committee do not actually conduct research – they merely review already-conducted research.   Specifically, we recommend the inclusion of ‘or animals’ in legislation relative to the consideration of research with regards to toxic exposures.”  For example, it would be highly unethical to seek to conduct medical research on the long-term health effects of low-dose sarin nerve agent or mustard gas on human subjects.  Thus, such toxic exposure research must, by necessity, be conducted solely on laboratory animals (which have been primarily mice and rats).
  2. “Direct prior NAM/IOM reports be redone to include equal consideration of animal studies. These should be reconsidered to include animal studies of association between toxic exposures and health outcomes, including each NAM and IOM report on respiratory health, burn pits, and Gulf War veterans as has been broadly defined as beginning August 2, 1990 and to a date to be determined.”
  3. “Transparency in VA contracts with NAM. Past VA contracts with NAM for statutorily-mandated NAM reports on toxic exposures have been kept secret by VA.”  All past, present, and future VA contracts with NAS, “should be made public in a timely fashion, perhaps by an explicit requirement that they be published in the Federal Register prior to their execution and allowing for public comment, including by veterans service organization and advocates.”

Meanwhile, the statutory authority granted to the VA Secretary under 38 U.S.C. 1118 has been poorly used if at all to favorably determine new presumptive conditions for Gulf War veterans.

Conclusions

It is therefore concerning when we see legislative advocacy efforts that would essentially model after this VA-NAS process that has almost entirely failed Gulf War veterans, with more than two decades of VA reliance on it.

 

The few of us Gulf War veterans who remain active advocates on Gulf War veterans’ issues have seen something extremely troubling in our decades-long experience:  successive toxic exposure cohorts are each chemically, biologically, and toxicologically unique with their individual toxins and mixes of toxins.  However, the Department of Defense and the Department of Veterans Affairs have used consistent methodologies with each successive toxic exposure cohort, which have served to delay, deny, and wait until the toxin-exposed veterans die.

  • Creating registries, which are feel-good legislative and administrative advances, but which have had little apparent impact on veterans registered thereunder.
  • DoD and VA can never quite get research right, leading NAS to perpetually conclude, in essence, “more studies are needed” – an endless source of frustration for each successive toxic exposure cohort.The end result is affected veterans and military service members are not provided evidence-based healthcare relevant to the etiology of their toxic exposure-induced health conditions and are mostly denied when they make claims for service-connected disability benefits – the gateway to VA healthcare… or survivor benefits for the loved ones who have ultimately succumbed to their toxic exposures.
  • With no acknowledgment or accountability for toxic exposures, toxic hazards continue:burn pits keep burning; depleted uranium munitions continue to be used; pyridostigmine bromide “nerve agent protective pills” are still readied for use by our troops; and so on in seeming perpetuity without DoD ever acknowledging let alone learning the lessons of the past.
  • DoD and VA continue with business as usual, continuing in these regards in these now famous words from one of myriad Gulf War hearings: “mistaking motion for progress.”[i]

The Committee’s sincere interest in these very serious issues is deeply appreciated.   VA has failed and continues to fail Gulf War veterans.  It should therefore not be surprising to anyone that VA similarly continues to fail successive generations of veterans suffering the enduring health effects of toxic exposures.

We deeply appreciate your consideration and your interest in this critical matter.  For more than 20 years, VA has willfully subverted the explicit intent of Congress regarding the appropriate standard to be used in establishing associations – key to VA creating presumptions for VA claims determinations and the gateway to VA healthcare – where veterans were subjected to toxic exposures during their service.  We remain available to provide further detail on these topics as the Committee may see fit.

Respectfully,

Anthony Hardie
National Chair & Director

Veterans for Common Sense

Gulf War Veteran, U.S. Army; Chair Emeritus, Programmatic Panel, Gulf War Illness Research Program, Congressionally Directed Medical Research Program, U.S. Department of Defense; former Member (2005-2013), Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI), U.S. Department of Veterans Affairs; former Member (2005-2013), Gulf War Steering Committee, U.S. Department of Veterans Affairs; former Executive Assistant for Legislative, Public, & Intergovernmental Affairs, Wisconsin Department of Veterans Affairs; former National Vice-Chair, National Gulf War Resource Center.

 

FOOTNOTES:

[1] 38 CFR 4.12a, Diagnostic Code 8045, “Residuals of traumatic brain injury (TBI)”.

[2] LINK:  http://veteransforcommonsense.org/nasem-gulf-war-reports

[3] LINK: https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/

[4] Written submission for the record by James Binns, Roberta White, Anthony Hardie, Paul Sullivan for a hearing entitled: “Toxic Exposures: Examining Airborne Hazards In The Southwest Asia Theater Of Military Operations,” Subcommittee on Disability Assistance and Memorial Affairs, Committee On Veterans’ Affairs, U.S. House of Representatives, Washington, DC (September 23, 2020).

[5] National Research Council 2020. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations. Washington, DC: The National Academies Press. https://doi.org/10.17226/25837

[6] National Academy of Medicine.  September 11, 2020.  New Approaches Are Needed to Determine Whether Respiratory Health Problems Are Associated With Military Deployment to the Persian Gulf Regionhttps://www.nationalacademies.org/news/2020/09/new-approaches-are-needed-to-determine-whether-respiratory-health-problems-are-associated-with-military-deployment-to-the-persian-gulf-region

[7] Institute of Medicine, Board on the Health of Select Population, Committee on the Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan.  October 31, 2011.  News Release: Evidence Inconclusive About Long-Term Health Effects of Exposure to Military Burn Pitshttps://www.nationalacademies.org/news/2011/10/evidence-inconclusive-about-long-term-health-effects-of-exposure-to-military-burn-pits

[8] IOM 2011. Long-term health consequences of exposure to burn pits in Iraq and Afghanistan. Washington, DC: The National Academies Press.  https://www.nap.edu/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan

[9] 38 U.S.C. 1118:  “(b)(1)(A) Whenever the Secretary makes a determination described in subparagraph (B), the Secretary shall prescribe regulations providing that a presumption of service connection is warranted for the illness covered by that determination for purposes of this section.

(B) A determination referred to in subparagraph (A) is a determination based on sound medical and scientific evidence that a positive association exists between—

(i) the exposure of humans or animals to a biological, chemical, or other toxic agent, environmental or wartime hazard, or preventive medicine or vaccine known or presumed to be associated with service in the Southwest Asia theater of operations during the Persian Gulf War; and

(ii) the occurrence of a diagnosed or undiagnosed illness in humans or animals.

(2)(A) In making determinations for purposes of paragraph (1), the Secretary shall take into account—

(i) the reports submitted to the Secretary by the National Academy of Sciences under section 1603 of the Persian Gulf War Veterans Act of 1998; and

(ii) all other sound medical and scientific information and analyses available to the Secretary.

(B) In evaluating any report, information, or analysis for purposes of making such determinations, the Secretary shall take into consideration whether the results are statistically significant, are capable of replication, and withstand peer review.

(3) An association between the occurrence of an illness in humans or animals and exposure to an agent, hazard, or medicine or vaccine shall be considered to be positive for purposes of this subsection if the credible evidence for the association is equal to or outweighs the credible evidence against the association.” [emphasis added] https://www.govinfo.gov/app/details/USCODE-2011-title38/USCODE-2011-title38-partII-chap11-subchapII-sec1118

[10] IOM News Release, October 30, 2020.

[11] IOM 2011, p. 5:  http://books.nap.edu/openbook.php?record_id=13209&page=5

[12] Binns et al.

[i] Rep. Chris Shays (R-CT), during a hearing entitled, “DOD Chemical and Biological Defense Program: Management and Oversight,” by the Subcommittee on National Security, Veterans Affairs, and International Relations of the Committee on Government Reform, U.S. House of Representatives, 106th Congress; May 24, 2000.  Link:  https://www.govinfo.gov/content/pkg/CHRG-106hhrg71624/html/CHRG-106hhrg71624.htm     

Posted in Burn Pits, Gulf War Updates, Legislative News, Toxic Wounds, VA Claims Updates, VCS Congressional Testimony | Comments Off on Veterans for Common Sense Provides Testimony for Congressional Hearing on Toxic Exposure Presumptive Conditions

Veterans for Common Sense Leaders Provide Testimony for Congressional Hearing on Toxic Exposure Research

(Washington – September 23, 2020) – The leaders of Veterans for Common Sense co-authored written testimony for today’s Congressional hearing on the military toxic exposure research.

The House Committee on Veterans’ Affairs, Subcommittee on Disability Assistance and Memorial Affairs held today’s oversight hearing entitled: “Toxic Exposures: Examining Airborne Hazards in the Southwest Asia Theater of Military Operations.”

The testimony was co-authored by James H. Binns, longtime former Chair of the congressionally chartered Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI; Dr. Roberta White, past scientific director of the RAC; Paul Sullivan, Veterans for Common Sense National Vice Chair and who helped author the first RAC charter following successful enactment of the 1998 legislation directing its creation; and Anthony Hardie, National Chair and Director of Veterans for Common Sense.

The full text is below, or available in PDF download: Statement for the Record – BINNS, WHITE, HARDIE, SULLIVAN – September 23, 2020 Toxic Exposures HVAC-DAMA

*****

STATEMENT FOR THE RECORD
OF
JAMES BINNS, ROBERTA WHITE, ANTHONY HARDIE, & PAUL SULLIVAN

FOR A SEPTEMBER 23, 2020 HEARING
OF THE
COMMITTEE ON VETERANS’ AFFAIRS,
SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS
ENTITLED:
“TOXIC EXPOSURES: EXAMINING AIRBORNE HAZARDS IN THE SOUTHWEST ASIA THEATER OF MILITARY OPERATIONS”

 

Chairwoman Luria, Ranking Member Bost, and Members of the Subcommittee, thank you for your leadership in introducing the Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020.  We are grateful to the bill’s authors for including presumptions for service-connection for any cancer and a list of specified respiratory conditions.  We are also grateful that the definition of who is covered by these presumptions includes: post-9/11 veterans exposed to open air burn pits and airborne hazards; veterans with Persian Gulf service since August 2, 1990 (including veterans awarded the Southwest Asia Service Medal for their Persian Gulf War service); and veterans with special operations and other contingency service in a long list of countries since that date.

Collectively in our individual roles, we led the passage of the 1998 legislation creating the congressionally-mandated Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI); authored its charter; served as its chair, scientific director, and advocates for affected veterans; co-authored its groundbreaking reports.  From these deeply engaged leadership perspectives, we feel an obligation to point out near-certain outcomes should the bill proceed without ensuring that future reviews directed under the legislation also include both human and animal studies of toxic exposures.

This gravely serious problem has been made apparent by the many reports released by the National Academies in these regards, including the recent report[i] and related news release of a National Academy of Medicine (NAM) committee on respiratory health effects among veterans who served in Southwest Asia. “The current uncertainty should not be interpreted as meaning that there is no association — rather, the issue is that the available data are of insufficient quality to draw definitive conclusions,” said the committee chair in a news release about the report.[ii]  Similarly, a 2011 National Academies (Institute of Medicine (IOM)) committee concluded there is, “[i]nsufficient data on service members’ exposures to emissions from open-air burn pits,” and that this, “is one of the reasons why it is not possible to say whether these emissions could cause long-term health effects.”  However, “the committee pointed out shortcomings in research and gaps in evidence that prevented them from drawing firm conclusions…”.[iii]

The major problem with this recent NAM report on veterans’ respiratory health issues, and with the related 2011 IOM burn pits report,[iv] and with the entire compendium of NAM/IOM reports related to burn pits exposure and Gulf War exposures and health is not that there are no good human studies – though that is indeed a true statement.  Instead, the real problem is that VA has failed to follow the law by failing to require that NAS reports consider scientific evidence in humans and animals.

Congress in 1998 established the standard for finding an association between toxic exposures and illness in veterans of the 1991 Gulf War.  Congress directed that VA and the National Academy of Sciences consider the exposure of humans and animals to specified toxins, the occurrence of illness in both humans and animals, and the associations between occurrence of illness in both humans and animals [38 U.S.C. 1118].[v]  Congress repetitively specified this explicit directive of both human and animal studies because its Members and staff knew that most studies of toxic substances are necessarily done in animals.

However, VA (and, by consequence, the VA-contracted NAM/IOM) did just the opposite, using a standard that limited consideration of associations between illness and exposure to solely human studies This deeply corrupted standard has been used in all subsequent NAS reports on Gulf War exposures and burn pits, and in effect ensures no association can ever be found. 

If the VA-contracted NAM were to follow the law requiring equal consideration of human and animal studies of toxic exposure, they would reach dramatically different conclusions about the serious and lasting effects of these toxins on veterans’ health.  The recent NAM respiratory health committee noted that the reason for its negative conclusion is that there are no good human studies: “The current uncertainty should not be interpreted as meaning that there is no association — rather, the issue is that the available data are of insufficient quality to draw definitive conclusions.”[vi]

Even more dramatically, the 2011 IOM burn pits report found: “Chemicals in all three major classes of chemicals detected [from burn pits at Joint Base Balad, Iraq] … have been associated with long-term health effects.  A wide array of health effects have been observed in humans and animals after exposure to the specific pollutants detected ….  The health-effects data on the other pollutants detected include: neurological effects, liver toxicity and reduced liver function, cancer, respiratory toxicity and morbidity, kidney toxicity and reduced kidney function, blood effects, cardiovascular toxicity and morbidity, reproductive and developmental toxicity.”[vii] However, the report’s conclusion considered only the sharply limited human studies, excluding this evidence and finding no association relevant to exposed veterans’ health.

In short, the problem is not the science.  The problem is the corruption of science through the application of impossible and unlawful standards.  The result is a large stack of expensive NAM and IOM reports that do little to nothing to improve the health and lives of veterans suffering the ill effects of toxic exposures from their exposures to burn pits and during the Gulf War.

Past performance seems likely to be a predictor of future performance.  Unless animal studies of toxic exposure are explicitly directed in all legislation that directs NAM studies related to toxic exposures and veterans’ health, it is unclear how future NAM considerations of strength-of-association determinations will result in any outcomes more favorable to veterans than NAM to date.  And, unless the use of the corrupted standard described above is changed, future NAM reports will be similarly unhelpful to the veterans suffering these adverse health outcomes resulting from their military toxic exposures.

 

Recommendations

  1. Amend the legislation to ensure the inclusion of animal studies. It is worth noting that in most cases, the animal studies of relevance have already been conducted, and such inclusion would not explicitly authorize nor require additional studies; indeed, these NAM committee do not actually do conduct research – they merely review already-conducted research.   Specifically, we recommend the inclusion of “or animals” in each of the six places solely “human” currently appears (additions are underscored; deletions are struck-through), as follows:
    1. Amend Section 2(b), “Process to Add Diseases Through Written Petition,” as follows: (b)(1)(A) – “the exposure of humans or animals to one or more covered toxins; and”; and, (b)(1)(B) – “the occurrence of the disease in humans or animals.”
    2. Amend Section 2(c), “Determinations by National Academies,” as follows: (c)(2)(A)(i) – “the exposure of humans or animals to one or 11 more covered toxins; and”
    3. Amend Section 3, title, as follows: “SEC. 3. AGREEMENT WITH THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE CONCERNING THE EXPOSURE OF HUMANS TO BURN PITS AND OTHER TOXINS.”
    4. Amend Section 3 as follows:(b)(1) – “Under an agreement between the Secretary and the National Academies, the National Academies shall review and summarize the scientific evidence, and assess the strength thereof, concerning the association between the exposure of humans or animals to covered toxins and each disease suspected to be associated with such exposure.”
    5. Amend Section 3 as follows:(c)(1) – “For each disease reviewed under subsection (b), the National Academies shall determine (to the extent that available scientific data permit meaningful determinations) whether there is a positive association between the exposure of humans or animals to one or more covered toxins and the occurrence of the disease in humans or animals, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association.
  1. Direct prior NAM/IOM reports be redone to include equal consideration of animal studies. These should be reconsidered to include animal studies of association between toxic exposures and health outcomes, including each NAM and IOM report on respiratory health, burn pits, and Gulf War veterans as has been broadly defined as beginning August 2, 1990 and to a date to be determined.
  1. Transparency in VA contracts with NAM. Past VA contracts with NAM for statutorily-mandated NAM reports on toxic exposures have been kept secret by VA.  These contracts should be made public in a timely fashion, perhaps by an explicit requirement that they be published in the Federal Register prior to their execution and allowing for public comment, including by veterans service organization and advocates.

We deeply appreciate your consideration and your interest in this critical matter.  For at least 20 years, VA has willfully subverted the explicit intent of Congress regarding the appropriate standard to be used in establishing associations – key to VA creating presumptions for VA claims determinations and the gateway to VA healthcare – where veterans were subjected to toxic exposures during their service.

This is a rare opportunity to give affected veterans the justice they deserve and to ensure that the results of this intentional misuse and manipulation of science are not inflicted on future generations of American veterans.  We would be pleased to provide further detail on these topics and to meet with you virtually.

Respectfully,

James Binns

Former Chair (2002-2014), Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC-GWVI), U.S. Department of Veterans Affairs (VA); former Principal Deputy Assistant Secretary of Defense for International Security Policy, U.S. Department of Defense

Roberta White, PhD

Former Chair, Department of Environmental Health at Boston University; Former Scientific Director (2008-15) and Member, RAC-GWVI

Anthony Hardie

Gulf War Veteran, U.S. Army; Chair Emeritus, Programmatic Panel, Gulf War Illness Research Program, Congressionally Directed Medical Research Program, U.S. Department of Defense; National Chair and Director, Veterans for Common Sense; former Member (2005-2013), RAC-GWVI; former Executive Assistant for Legislative, Public, & Intergovernmental Affairs, Wisconsin Department of Veterans Affairs; former National Vice-Chair, National Gulf War Resource Center

Paul Sullivan

Gulf War Veteran, U.S. Army; Former Deputy Secretary, California Department of Veterans Affairs; Director of Veteran Outreach, Bergmann & Moore, LLC; National Vice Chair, Veterans for Common Sense; former Project Manager, U.S. Department of Veterans Affairs; past Executive Director, National Gulf War Resource Center; Advocate for both 1994 and 1998 Persian Gulf War Veteran research and benefits laws that created the RAC-GWVI and the mandated NAM reviews.”

 

END NOTES:

[i] National Research Council 2020. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations. Washington, DC: The National Academies Press. https://doi.org/10.17226/25837

[ii] National Academy of Medicine.  September 11, 2020.  New Approaches Are Needed to Determine Whether Respiratory Health Problems Are Associated With Military Deployment to the Persian Gulf Regionhttps://www.nationalacademies.org/news/2020/09/new-approaches-are-needed-to-determine-whether-respiratory-health-problems-are-associated-with-military-deployment-to-the-persian-gulf-region

[iii] Institute of Medicine, Board on the Health of Select Population, Committee on the Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan.  October 31, 2011.  News Release: Evidence Inconclusive About Long-Term Health Effects of Exposure to Military Burn Pitshttps://www.nationalacademies.org/news/2011/10/evidence-inconclusive-about-long-term-health-effects-of-exposure-to-military-burn-pits

[iv] IOM 2011. Long-term health consequences of exposure to burn pits in Iraq and Afghanistan. Washington, DC: The National Academies Press.  https://www.nap.edu/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan

[v] 38 U.S.C. 1118:  “(b)(1)(A) Whenever the Secretary makes a determination described in subparagraph (B), the Secretary shall prescribe regulations providing that a presumption of service connection is warranted for the illness covered by that determination for purposes of this section.

(B) A determination referred to in subparagraph (A) is a determination based on sound medical and scientific evidence that a positive association exists between—

(i) the exposure of humans or animals to a biological, chemical, or other toxic agent, environmental or wartime hazard, or preventive medicine or vaccine known or presumed to be associated with service in the Southwest Asia theater of operations during the Persian Gulf War; and

(ii) the occurrence of a diagnosed or undiagnosed illness in humans or animals.

(2)(A) In making determinations for purposes of paragraph (1), the Secretary shall take into account—

(i) the reports submitted to the Secretary by the National Academy of Sciences under section 1603 of the Persian Gulf War Veterans Act of 1998; and

(ii) all other sound medical and scientific information and analyses available to the Secretary.

(B) In evaluating any report, information, or analysis for purposes of making such determinations, the Secretary shall take into consideration whether the results are statistically significant, are capable of replication, and withstand peer review.

(3) An association between the occurrence of an illness in humans or animals and exposure to an agent, hazard, or medicine or vaccine shall be considered to be positive for purposes of this subsection if the credible evidence for the association is equal to or outweighs the credible evidence against the association.” [emphasis added] https://www.govinfo.gov/app/details/USCODE-2011-title38/USCODE-2011-title38-partII-chap11-subchapII-sec1118

[vi] IOM News Release, October 30, 2020.

[vii] IOM 2011, p. 5:  http://books.nap.edu/openbook.php?record_id=13209&page=5

Posted in Burn Pits, Gulf War Updates, Legislative News, Research, Toxic Wounds, VCS Congressional Testimony, VCS In The News, Veterans for Common Sense News | Comments Off on Veterans for Common Sense Leaders Provide Testimony for Congressional Hearing on Toxic Exposure Research

Veterans for Common Sense among 104 organizations calling for Congress to complete annual Appropriations bills stalled in the Senate

Failure to soon enact the fiscal year 2021 Defense Appropriations Act will result in cessation of critical Servicemembers and veteran medical research programs affecting veterans with Gulf War Illness and Burn Pits exposure

(Washington – September 10, 2020) – Today, 104 health and veteran advocacy organizations, including Veterans for Common Sense, joined in calling on Congressional leadership to work to enact the annual Defense spending bill that is currently stalled in the U.S. Senate.

Currently, a short-term continuing resolution has been proposed to prevent a government shutdown, which would result if the various annual spending bills already passed by the U.S. House are not enacted.  A full-year continuing resolution would result in defunding, and cessation, of the critically important Congressionally Directed Medical Research Program (CDMRP).

Veterans for Common Sense annually fights for annual renewal of the treatment-focused Gulf War Illness Research Program (GWIRP) and pushed for restoration of the Burn Pits Exposure topic area within the CDMRP’s Peer Reviewed Medical Research Program.

Earlier this year, Veterans for Common Sense and Vietnam Veterans of America (VVA) also pushed for the inclusion of medical research regarding peripheral neuropathy, a debilitating condition that affects 30 million Americans including countless thousands of veterans.  Vietnam War veterans appear to be significantly affected, and recent research has connected at least one form of peripheral neuropathy to service in the 1991 Gulf War.

Joining the The Quinism Foundation, Veterans for Common Sense also pushed for the U.S. Senate earlier this year to fund critical research into the chronic adverse neurological and psychiatric effects of mefloquine and related quinoline antimalarial drugs, following release of a report by a committee of the National Academy of Medicine (NAM).  The NAM committee was charged with looking at “long-term health effects” of antimalarial medication, with “special attention” “to possible long-term neurologic effects,” and “long-term psychiatric effects” — prevalent concerns among current and former military service members who took the drugs during military service in malaria-endemic regions.  These advocacy efforts were overcome by the COVID-19 pandemic and the politicization of one antimalarial drug later found to be ineffective for the treatment of COVID-19, and the Senate did not include the request.

The letter joined by Veterans for Common Sense calls for Congress to work to enact the Fiscal Year 2021 Defense Appropriations Act, to ensure that the Defense Health Research Programs, including the CDMRP, are fully funded next year.

The full text is below.

*****

September 10, 2020

The Honorable Nancy Pelosi                    The Honorable Mitch McConnell
Speaker of the House                                 Majority Leader, U.S. Senate
Washington, DC 20515                              Washington, DC 20510

The Honorable Kevin McCarthy                The Honorable Chuck Schumer
Minority Leader                                            Minority Leader
U.S. House of Representatives                  U.S. Senate
Washington, DC 20515                               Washington, DC 20510

Dear Speaker Pelosi, Majority Leader McConnell, Minority Leader McCarthy, and Minority Leader Schumer:

We, the undersigned organizations urge you to work toward the enactment of the fiscal year 2021 Defense Appropriations Act, to ensure that the Defense Health Research Programs, including the Congressionally Directed Medical Research Programs (CDMRP), are fully funded in fiscal year 2021.

Our organizations understand that Congress may need to pass a short-term continuing resolution to prevent a government shutdown on October 1. However, we are particularly concerned about the possibility of Congress enacting a year-long continuing resolution in lieu of completing the fiscal year 2021 Defense Appropriations Act. Under a year-long continuing resolution the CDMRP would receive no funding in fiscal year 2021. Failure to enact the Defense Appropriations Act will have major negative health implications for the millions of Americans – especially veterans, military service members and their families – who live with chronic and debilitating disorders. This will delay important new discoveries and translation of medical innovation into new treatments and cures for many disorders.

We collectively represent millions of American veterans, military retirees, military families, and civilians who benefit from the ongoing research funded by the Defense Health Research Programs at the Department of Defense (DoD).  We have worked tirelessly to advocate for continued funding for the programs, and we were pleased to see that the House version of the fiscal year 2021 Defense Appropriations Act includes strong funding levels for medical research.

The Defense Health Research Programs will be unable to fully prepare for the fiscal year 2021 grant solicitation process until they receive a fully-enacted fiscal year 2021 budget. The CDMRP annually receives more than 12,000 pre-applications and 7,000 full applications for grants and undergoes a rigorous process to evaluate and fund the best of these applications. Further delay in enacting the fiscal year 2021 appropriations bill will create unnecessary disruption with internal processes at DoD.

These delays will have systemic impacts on the way the DoD convenes programmatic panels to identify and implement programmatic changes and peer-review panels to provide thorough review of grant applications, and ultimately impact the ability of the DoD to conduct appropriate negotiations to award fiscal year 2021 grants. Further, failure to enact a fully-funded fiscal year 2021 budget will compromise the ability of scientific laboratories across the U.S to effectively plan and prepare the highest quality grant applications, potentially diminishing opportunities to maintain discovery-based research programs and disrupting critical scientific workforces.

The CDMRP is a critical component of the Defense Appropriations Act, and failure to enact this legislation will have a devastating impact on the program.  Aside from the obvious biomedical and economic consequences of such actions, such as stalling or eliminating the critical development of new and more effective therapies that lower costs and save lives, failure to enact will interrupt important pipelines that have allowed investigators at U.S. medical research institutions to build careers and act on new and innovative medical research ideas.

We therefore urge you to work together in a bipartisan, bicameral spirit and enact the fiscal year 2021 Defense Appropriations Act.

Sincerely,

Action to Cure Kidney Cancer

ALS Association

American Academy of Allergy, Asthma & Immunology

American Academy of Dermatology Association

American Academy of Neurology

American Association for Cancer Research

American Association for Dental Research

American Autoimmune Related Diseases Association

American Brain Tumor Association

American College of Rheumatology

American Gastroenterological Association

American Psychological Association

American Society for Gastrointestinal Endoscopy

American Society for Microbiology

American Urological Association

Aplastic Anemia and MDS International Foundation

APS Foundation of America, Inc

Arthritis Foundation

Asbestos Disease Awareness Organization

Association of American Cancer Institutes

Asthma and Allergy Foundation of America

Batten Disease Support and Research Association

Bladder Cancer Advocacy Network

Bridge the Gap – Syngap Education and Research Foundation

Buoniconti Fund to Cure Paralysis

Burn Pits 360 Veterans Organization

Cancer ABCs

Charlie Foundation

Child Neurology Foundation

Children’s Tumor Foundation

Christopher & Dana Reeve Foundation

Citizens United for Research in Epilepsy (CURE)

Coalition for National Security Research

Colorectal Cancer Alliance

Cure HHT

Danny Did Foundation

Deadliest Cancers Coalition

Debbie’s Dream Foundation: Curing Stomach Cancer

debra of America

Duke Health

Duke University

Epilepsy Foundation

Epilepsy Leadership Council

Fight Colorectal Cancer

Foundation to Eradicate Duchenne

George Mason University

Global Health Technologies Coalition

GO2 Foundation for Lung Cancer

Harvard University

Hepatitis B Foundation

HIV Medicine Association

Indiana University

Infectious Diseases Society of America

International Myeloma Foundation

International Pemphigus Pemphigoid Foundation

KidneyCAN

Kidney Cancer Association

LAM Foundation

LGS Foundation

Littlest Tumor Foundation

Living Beyond Breast Cancer

Lupus and Allied Diseases Association, Inc.

Lupus Foundation of America

Lymphoma Research Foundation

Melanoma Research Foundation

Miami Project to Cure Paralysis

Michigan State University

National Alliance for Eye and Vision Research

National Alliance of State Prostate Cancer Coalitions

National Association of Nurse Practitioners in Women’s Health (NPWH)

National Autism Association

National Brain Tumor Society

National Fragile X Foundation

National Multiple Sclerosis Society

National Pancreas Foundation

National Vietnam and Gulf War Veterans Coalition

Neurofibromatosis Midwest

Neurofibromatosis Network

Neurofibromatosis Northeast

Ovarian Cancer Research Alliance

Pancreatic Cancer Action Network

Parent Project Muscular Dystrophy

PKD Foundation

Prostate Cancer Clinical Trials Consortium

Prostate Cancer Foundation

Prostate Conditions Education Council

Pulmonary Fibrosis Foundation

Research!America

Scleroderma Foundation

Sergeant Sullivan Circle

SHEPHERD Foundation

Sjögren’s Foundation

SLC6A1 Connect

St. Baldrick’s Foundation

Susan G. Komen

Texas NF Foundation

Tuberous Sclerosis Alliance

University of Central Florida

University of Iowa

Veterans for Common Sense

VHL Alliance

Wayne State University

Weill Cornell Medicine

ZERO-The End of Prostate Cancer

 

cc:  House and Senate Committee on Appropriations

###

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Veterans for Common Sense Letter to VA Regarding Predatory Corporate Schools

SUBJECT: Commonsense Suggestions re: 38 USC 3696

June 18, 2020

Dear Under Secretary Lawrence,

On April 9, Veterans for Common Sense was among 33 veterans organizations that co-signed the attached letter to Secretary Wilkie regarding improper GI Bill payments to ineligible colleges, especially those that should not be approved for GI Bill under 38 U.S.C. 3696.

In that letter, we collectively provided the following commonsense recommendations to the Secretary to help determine whether schools in violation of 38 U.S.C. 3696 have demonstrated sufficient “corrective action” to restore GI Bill eligibility:

  • Faced sufficient deterrence commensurate with the harm against veterans;
  • Is a repeat law-offender;
  • Put in place an independent auditor to verify future recruiting and advertising practices;
  • Replaced the executives responsible for the illegal conduct;
  • Removed pressure on recruiters to enroll students at all costs; and
  • Undergone a risk-based review by the State Approving Agency.

Also attached is a fact sheet entitled, “Many Corporate School Chains Repeatedly Settled Lawsuits for Misleading Advertising, High-Pressure Recruiting, and False Certifications.”  This fact sheet was developed by Veterans Education Success, which we have been proud to closely partner with since its inception and continue to very strongly support in collaborative efforts to preserve and enhance veterans’ federally-funded education programs and to protect veterans from predatory entities and practices.  As the title of the fact sheet implies, it shows that many of these schools under consideration are repeat offenders in these regards.

As the Department of Veterans Affairs makes these crucial determinations relative to protecting veterans from these predatory institutions, we want to take this opportunity to again highlight these recommendations and the attached documents.

Thank you for your reasoned consideration of these matters, which stand to impact countless veterans.

On behalf of Veterans for Common Sense and with appreciation for your efforts on behalf of veterans,

-Anthony

Anthony Hardie,
National Chair & Director
Veterans for Common Sense
1140 3rd St. NE, Spc 2138
Washington, DC 20002-6274
www.VeteransforCommonSense.org

 

 

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