VCS weighs in on future of the VA in the new Administration, in two national news stories

(Washington – January 18, 2017) – Veterans for Common Sense (VCS) was quoted twice this week in the national press about prospects for the U.S. Department of Veterans Affairs (VA) in the new Administration.

A Healthline feature story published yesterday by award-winning journalist Jamie Reno, which highlighted what may lay ahead for VA in the new Administration, includes extensive VCS quotes. [SOURCE:  Healthline, “Will Healthcare for Veterans Improve Under President Trump? The president-elect’s selection of David Shulkin as Secretary of Veterans Affairs has drawn praise, but some advocates still worry about privatizing the agency.”, Jamie Reno, January 17, 2017.]

The Healthline article gives voice to several veteran leaders with concerns of possible privatization of VA healthcare, a major area of VCS concern.  Reno lays out the progress made by the current Administration, but also details the many serious challenges that continue to face VA, including unacceptably high veteran suicide rates, VA claims denials, VA healthcare wait times, staffing, and the challenges of meeting the needs of women veterans.  VCS has done extensive work since its founding in 2002 on nearly all of these key priorities.

Concerns about VA privatization may be less likely to be realized following the appointment of current VA Undersecretary for Health Dr. David Shulkin.

Vietnam Veterans of America (VVA) President John Rowan had praise for Shulkin’s work in fixing VA.  “Dr. Shulkin came out of the private sector less than two years ago,” Rowan explained in the Healthline article. “He has been relentless in his pursuit of improving medical care for veterans, working to increase timely access, all the while holding managers and other VA staff accountable.

The day of the announcement of Shulkin’s nomination, the L.A. Times quoted VCS’s press statement about the nomination:  “Another group, Veterans for Common Sense, said it was “relieved” by Trump’s pick of Shulkin,”  [SOURCE:  Los Angeles Times, “Trump picks Obama appointee to lead Veterans Affairs. Has he cooled on his plan to overhaul it?”, Evan Halper, January 11, 2017.]

The Healthline article also describes the plight of Gulf War veterans and other veterans with toxic wounds — areas of major VCS focus by Veterans for Common Sense:

Anthony Hardie, a Gulf war veteran, and longtime advocate for his fellow veterans, has spoken before Congress many times on the profound harms veterans have suffered through exposure to multiple toxins while on duty. He is cautiously optimistic about what Shulkin can accomplish if given the chance.

“There’s a lot of very old swamp the new president could help drain, forcing the VA to finally fulfill its long-untapped potential to really help countless toxic-wounded veterans,” said Hardie, the director of Veterans for Common Sense.

Hardie believes the VA is “uniquely situated” to learn from and treat veterans with toxic wounds.

“Veterans with Agent Orange exposure, for example, have had many disability ‘presumptives’ approved by VA, but far too many Vietnam veterans have died young, leaving it all to surviving spouses and children,” he told Healthline.

Hardie added that one-third of his fellow 1991 Gulf War veterans with Gulf War Illness remain chronically ill because of toxic exposures.

“Yet they suffer an 80 percent VA claims denial rate,” he explained. “And post-9/11 veterans exposed to burn pits or Iraqi chemical warfare agents are even worse situated, and it doesn’t stop there.”

Read the full Healthline story at:

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Veterans for Common Sense Statement on Appointment of New VA Secretary  

(Washington – January 11, 2017)  – Veterans for Common Sense, a Washington, DC-based veterans organization, today released the following statement regarding the appointment of David Shulkin, M.D. as Secretary of the U.S. Department of Veterans Affairs (VA):

“After substantial public discussion regarding possible wholesale privatization of VA healthcare, we are relieved by today’s announcement. 

“We support the appointment as VA Secretary of Dr. David Shulkin, an accomplished medical doctor with significant VA and private sector experience running large and complex healthcare organizations.

“VA is of course much more than just a healthcare provider, and Dr. Shulkin’s current VA experience should lend itself well to this expanded role.  While VA has many enduring challenges, a common-sense approach to solving them can only succeed.

“Our veterans deserve the very best healthcare, medical research, benefits, programs, and services that we as a nation can provide.  That means fully funding the VA, fixing VA’s many challenges, and ensuring veterans receive the assistance they need at the time they need it.”

# # #

Dr. David Shulkin currently serves as Undersecretary of Health for the U.S. Department of Veterans Affairs, a position to which he was appointed in 2015 by President Obama and confirmed unanimously by the Republican-controlled U.S. Senate.

Shulkin’s public bio is available at:

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NSU Scientists Study Disease that Impacts Hundreds of Thousands of Gulf War Veterans


Nova Southeastern University Researchers Receive More Than $1.8 Million in Grants from U.S. Army to Examine Causes of Gulf War Illness

FORT LAUDERDALE-DAVIE, Fla. – As the nation honors our veterans on November 11, we must pause to remember the

long-lasting health effects soldiers experience not only from bullets or bombs, but from exposure to unexplained pesticides, radiation or other toxins during their time in the service.

At least a quarter of the 700,000 soldiers who fought in the 1991 Gulf War suffer from a debilitating disease called Gulf War illness (GWI).

GWI is a medical condition that affects both men and women and is associated with symptoms including fatigue, chronic headaches, memory problems, muscle and joint pain, gastrointestinal issues, neurological problems, respiratory symptoms, hormonal imbalance and immune dysfunction.

Researchers at Nova Southeastern University (NSU) are conducting multiple studies to learn more about and ultimately help veterans facing GWI. Two NSU research teams recently received grants from the U.S. Army Medical Research Acquisition Activity totaling $1,830,389 to fund three studies.

  • Improving Diagnostics and Treatments for GWI Females by Accounting for the Effects of PTSD– $655,822 (Travis Craddock, Ph.D., principal investigator)
  • Disentangling the Effects of PTSD from GWI for Improved Diagnostics and Treatments2– $592,825 (Travis Craddock, Ph.D., principal investigator)
  • Persistently Elevated Somatic Mutation as a Biomarker of Clinically Relevant Exposures in Gulf War Illness3 – $581,742 (Stephen Grant, Ph.D., principal investigator)

The first two, three-year studies1&2 are aimed at identifying subgroups of GWI based on the presence or absence of posttraumatic stress disorder (PTSD) resulting from time on the battlefield in both men and women. Dr. Craddock and his research team will perform a systems biology analysis to isolate biobehavioral profiles that identify the effects of PTSD in GWI to improve diagnostic criteria and to assess potential treatment avenues for GWI in the context of probable PTSD diagnosis.

GWI is at least in part caused by illness-specific inflammatory activity. The extent and nature of the resulting inflammation may be altered in people who also experience PTSD, leading to a shift in treatment targets/strategies for each subtype. Specifically, Dr. Craddock’s team aims to understand the role of systemic inflammatory mechanisms in GWI in the presence and absence of probable PTSD diagnosis as this is critical to define subtypes of GWI, and for the development of subtype-specific treatments.

Travis Craddock, Ph.D., assistant professor in the NSU College of Psychology’s Department of Psychology and Neuroscience, and associate director of the NSU Institute for Neuro-Immune Medicine’s Clinical Systems Biology Group, is the principal investigator for the first two studies. His research team includes Nancy Klimas, M.D., director, NSU Institute for Neuro-Immune Medicine; Gordon Broderick, Ph.D., director, NSU Institute for Neuro-Immune Medicine’s Clinical Systems Biology Group; and Stephen Messer, Ph.D., associate professor, NSU College of Psychology’s Department of Clinical Psychology.

The final three-year study3 is based on the idea that long-term effects of exposures from service in the Gulf Wars are due to damage affecting the regenerative stem cells of the body. Dr. Grant and his research team will examine the cumulative effects of many types of exposures that can damage DNA in cells (genotoxicity) using blood samples from patients with GWI to help determine possible causes of the disease using a patent-pending biodosimetric technique.

Rather than identify a single agent as cause for GWI, the study proposes that it is due to the cumulative effect of all exposures. Results of the study could be used to develop new treatments and screen patients to predict who is at greatest risk of developing symptomatic GWI.

Stephen Grant, Ph.D., associate professor in Nova Southeastern University (NSU) College of Osteopathic Medicine’s Master of Public Health Program, is the principal investigator for the latter study. His research team includes Nancy Klimas, M.D., director, NSU Institute for Neuro-Immune Medicine; Mary Ann Fletcher, Ph.D., NSU’s Schemel Professor for Neuro-Immune Medicine; and Jean Latimer, Ph.D., director of the new NSU AutoNation Institute for Breast and Solid Tumor Cancer Research.

The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702- 5014 is the awarding and administering acquisition office. These works were supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Gulf War Illness Research Program under Award Nos. W81XWH-16-1-0632, W81XWH-16-1-0552 and W81XWH-16-1-0678. Opinions, interpretations, conclusions and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense.

# # #

 About Nova Southeastern University (NSU): Located in beautiful Fort Lauderdale, Florida, Nova Southeastern University (NSU) is a dynamic research institution dedicated to providing high-quality educational programs at the undergraduate, graduate, and first-professional degree levels. A private, not-for-profit institution, NSU has campuses in Fort Lauderdale, Fort Myers, Jacksonville, Miami, Miramar, Orlando, Palm Beach, and Tampa, Florida, as well as San Juan, Puerto Rico, while maintaining a presence online globally. For more than 50 years, NSU has been awarding degrees in a wide range of fields, while fostering groundbreaking research and an impactful commitment to community. Classified as a research university with “high research activity” by the Carnegie Foundation for the Advancement of Teaching, NSU is 1 of only 50 universities nationwide to also be awarded Carnegie’s Community Engagement Classification, and is also the largest private, not-for-profit institution in the United States that meets the U.S. Department of Education’s criteria as a Hispanic-serving Institution. Please visit www.nova.edufor more information about NSU and for more information on the largest fundraising campaign in NSU history.

SOURCE:  NSU Press release, November 10, 2016

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VCS Presents on Gulf War Guidelines to Federal VA Advisory Committee, Provides New Public Education Documents

(Veterans for Common Sense – August 8, 2016) – Veterans for Common Sense Director Anthony Hardie today presented to a U.S. Department of Veterans Affairs (VA) federal advisory committee regarding the impetus behind a new federal relook of clinical guidelines for Gulf War veterans suffering from Gulf War Illness.

The presentation, made by Dr. Stephen Hunt, VA’s Deployment Health Director, and Hardie, was to the Congressionally chartered VA Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC).  Their presentation included a discussion of new Congressional guidance related to Gulf War veterans’ issues.

The clinical guidelines, developed jointly by VA and the Department of Defense (DoD), came under sharp criticism during a February 23, 2016 Congressional hearing on Gulf War veterans issues.  One news headline read, “On Gulf War’s 25th Anniversary, Researchers & Veterans Say VA Failing to Treat Signature Injury:  Congressional Hearing Marks Persian Gulf War’s 25th Anniversary with Sharp Criticism of VA Clinical Guideline and VA-Contracted Institute of Medicine Report.”

According to testimony by Dr. Roberta White, PhD, head of the Boston University School of Public Health Environmental Health Department and immediate past Scientific Director for the RAC, the “treatment guideline that suggests ineffective, unproven and purely palliative treatments for Gulf War illness that focus on psychiatric symptomatology.”

“Even worse, multiple psychiatric medications are suggested in the treatment document that have significant adverse side effects. Even more disturbing, none of these medications has been studied with regard to its effectiveness in the treatment of Gulf War illness,” White continued.

VCS also testified at that hearing and at a subsequent hearing on Gulf War veterans’ disability claims denials by VA.

Today’s presentation before the VA federal advisory committee also included a discussion of new Congressional direction related to the nomenclature for Gulf War Illness — calling it by that name rather than one of a myriad of previous names VA has used for the signature health condition of the 1991 Gulf War.   Gulf War Illness has been shown in successive RAC and National Academy of Sciences Institute of Medicine scientific reports to affect between one-fourth and one-third of the veterans of the 1991 Gulf War.

The provisos are part of the annual appropriations bill for VA and were included by U.S. Senator Tammy Baldwin (D-WI), a member of the Senate Appropriations Committee.  According to an article in Healthline republished in the Huffington Post:

Baldwin’s provisions … would ‘improve the approval rates of veterans’ disability claims; enhance ongoing studies and research into the causes of and treatments for Gulf War Illness; and strengthen the membership and work of the Research Advisory Committee, which oversees the government’s research agenda.'”

“The Baldwin provisos give explicit Congressional direction on Gulf War research, claims, and healthcare — the most significant legislative action in many years.   Together, these measures represent an important step forward in holding VA accountable for its newly exposed 82 percent denial of Gulf War veterans’ claims and its rampant failures on Gulf War treatment and research,”  said Anthony Hardie, Gulf War veteran and Director, Veterans for Common Sense in a statement.

“We are tremendously grateful for Senator Baldwin’s leadership within the Senate Appropriations Committee to continue Gulf War treatment research and to author and enact these critically important accountability measures, which are critical to the one-third of Gulf War veterans who are still suffering from Gulf War Illness 25 years after the war.”

The new Congressional guidance is already having an effect on VA.  During today’s hearing, Dr. Stephen Hunt, Director of VA’s Deployment Health Clinic in Puget Sound, Washington, noted that new efforts include first revising the abbreviated pocket guide associated with the clinical guidelines.  Hardie expressed Gulf War veterans’ strong hope that a revision of the full guide will follow, as Congress has “urged”.

VCS has prepared two documents for public education related to the new Congressional guidance on Gulf War veterans.  The first is a PDF document that is an abridged version of the Senate Report, accompanying the appropriations bill, in which the guidance was included.  The second is a VCS PowerPoint presentation that makes the new guidance clear in a simple to use, point-by-point presentation.


VCS PowerPoint — New Congressional Gulf War guidance:  PPT – SAC Gulf War language

VCS PDF:   Baldwin Gulf War Provisos – S.Rpt. 114-237 Highlighted

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VA ends paper signature requirement for VA healthcare enrollment

The Department of Veterans Affairs (VA) announced today it has eliminated paper signature requirements for Veterans wishing to enroll in VA health care.  Effective immediately, VA has amended its enrollment regulations to allow Veterans to complete enrollment applications for enrollment in VA health care by telephone without the need for a paper signature. This action also accelerates VA’s effort to enroll all Combat Veterans with pending enrollments as part of its ongoing Veterans Enrollment Rework Project (VERP).

By adding this telephone application option to VA’s regulations with this amendment, VA will now offer three ways to enroll under 38 CFR 17.36(d) (1). This option provides Veterans a convenient third enrollment option in addition to the paper VA Form 10-10 EZ and the online health care application.To apply, call 1-877-222-VETS (8387), Mon-Fri between 8 am and 8 pm, EST.

SOURCE:  U.S. Department of Veterans Affairs email, Office of the Under Secretary for Health, July 5, 2016

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VCS Statement on Different Organization with Similar Sounding Name

(Washington – June 11, 2016) –
 Veterans for Common Sense today issued the following statement regarding a new initiative by another organization using a similar sounding name:

“To the best of our understanding, it appears that the leaders of a different organization, “Americans for Responsible Solutions” (, have recently announced a new initiative.  It is unfortunate that they have apparently chosen to name their new initiative, “Veterans Coalition for Common Sense“, which is very similar to and potentially infringing upon the name of our longstanding national organization, Veterans for Common Sense (VCS) (  

 To clarify, the “Veterans Coalition for Common Sense” initiative is entirely unrelated to, separate, and distinct from our Veterans for Common Sense (VCS) organization, which was founded in 2002 by a group of war veterans, incorporated in Washington, DC in 2003, and has been operating continuously in support of our mission since that time.  VCS has been active in supporting current and former military service members, educating the media and the public, testifying before Congress more than 30 times, and has been frequently quoted in the national press.

It is truly unfortunate that leaders of the other organization chose to use a name so similar to ours, which is already causing confusion.  We have already received numerous communications intended for their organization.

In the best interest of both organizations, and to prevent future confusion by policymakers, the press, and the public, we hope that Americans for Responsible Solutions will modify the name of their new initiative to prevent further confusion.”


Veterans for Common Sense, Inc. (VCS) was incorporated in 2003 to collect, analyze and disseminate information relevant to U.S. foreign and military policy for the use of the public in better decision making.  VCS works to highlight issues of public interest related to national defense, foreign policy, and current and former military service members.  VCS  is an all-volunteer organization led by U.S. war veterans.



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VCS Praises Senate Leadership for Preserving Medical Research


(Washington – June 7, 2016) – Veterans for Common Sense praised Senate leaders for passing an amendment today to preserve federal medical research – including the federal, treatment-focused Gulf War Illness Research Program strongly supported by VCS and Gulf War veterans.

The bipartisan amendment, led by Senators Richard Durbin (D-Illinois) and Thad Cochran (R-Mississippi), garnered more than 30 cosponsors and passed narrowly by a 66-32 vote today on the floor of the U.S. Senate. (S.Amdt #4369)

“We are truly grateful for the leadership of Senators Durbin and Cochran and so many of their colleagues who recognize the critical importance of this medical research and the real hope it provides to those suffering from debilitating injuries and illnesses,” said Anthony Hardie, director of Veterans for Common Sense. “Today’s passage of this amendment means critically important medical research efforts can continue as they should,” said Hardie.

Other medical research programs preserved by the amendment include research related to Amyotrophic Lateral Sclerosis (ALS), multiple sclerosis (MS), cancers, respiratory conditions, and an array of other health conditions afflicting countless current and former military service members, their families, and others. A burn pit exposure research program that was recently recommended for renewal by a Senate funding committee was among those protected by the amendment.

Many of the programs that were spared are administered by the Congressionally Directed Medical Research Program (CDMRP) under Congressional direction as part of the Department of Defense health program.

The amendment removed provisions in the National Defense Authorization Act (NDAA) for Fiscal Year 2017 (S. 2943) that would have curtailed current health research programs and hampered future research efforts.Graphic_Groups_ResearchNotRedTape_2

A national advocacy effort in support of the amendment even garnered its own hashtags on Twitter, Facebook, and other social media: #ResearchNotRedTape .

Despite being a relatively new and very small program by federal research standards, the Gulf War Illness Research Program has already found evidence suggesting Coenzyme Q10, Carnosine, Acupuncture, and a xylitol-based nasal spray may help diminish some Gulf War Illness symptoms.  The condition affects between one-fourth and one-third of veterans of the 1991 Gulf War has been linked to Gulf War toxic exposures.

In a Stars and Stripes article published today, “Senate wrangles over $1 billion in DOD medical research,” Disabled American Veterans Assistant National Legislative Director Adrian Atizado, himself a Gulf War veteran, is quoted in support of the programs spared by today’s amendment.

Disabled American Veterans opposed the McCain proposal, saying its members have benefited directly from the research program.

Adrian Atizado, DAV assistant national legislative director, said Gulf War Illness research initiated by Congress in 2006 could [also] help 600 veterans who were exposed to old chemical weapons during a disposal operation, and that wider research on multiple sclerosis and Lou Gehrig’s disease could also benefit the military because of the prevalence of the diseases among servicemembers and veterans.

“This research program is a peer-reviewed and competitive grant process led by scientists, clinicians and disease experts, and ensures that taxpayers’ dollars support only the most promising military-relevant research,” Atizado said.

Founded in 2003, Veterans for Common Sense is an all-volunteer, Washington, DC-based educational and advocacy organization that works to highlight issues of public interest related to national defense, foreign policy, and current and former military service members.  VCS is a member of the Defense Health Research Consortium, which supports Defense health research programs.


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VCS Provides Written Testimony for Congressional Hearing on Gulf War Veterans’ Claims Denials

Veterans for Common Sense provided the following invited written testimony for a March 15, 2016 Congressional hearing on Gulf War veterans’ benefits and disability claims denials.





Thank you, Chairmen Coffman and Abraham, Ranking Members Kuster and Titus, and Members of the Committee for today’s hearing and for this opportunity to present this information to you.

I’m Anthony Hardie, a 1991 Gulf War and Somalia veteran, and Director of Veterans for Common Sense. VCS and I have provided testimony on many previous occasions, most recently my testimony as a witness at your February 23, 2016 hearing on Gulf War veterans’ health outcomes on the 25th anniversary of the 1991 Gulf War.



As I noted in my testimony of February 23, 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 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.



The rates of VA’s denial of Gulf War veterans’ presumptive claims – for “undiagnosed illness” and for the “chronic multisymptom illnesses” such as Fibromyalgia, Irritable Bowel Syndrome/Functional Gastrointestinal Disorders, and Chronic Fatigue Syndrome – have been getting worse over time.

This worsening has been despite repeated high-level interventions by VA – interventions made ostensibly to improve VA’s review processes for Gulf War veteran’s presumptive claims.


2007 VA Denial Rate of Gulf War Veterans’ Presumptive Undiagnosed Illness Claims

In 2007 and 2008, I did a series of presentations about Gulf War veterans’ severe challenges with VA research, healthcare and benefits. The presentations were made to a number of national and regional groups around the country and were entitled, “Lost in the Shuffle”. Among the data presented was VA’s abysmal claims failures for Gulf War claims:

Based on a May 2007 report from VA’s Gulf War Information System (GWVIS), out of 696,842 Gulf War veterans, 280,623 had filed service-connected disability claims. Of those, 13,027 were “undiagnosed illness claims” (what VA terms “UDX” claims), just 3,384 had been approved – a 74 percent denial rate.


2010 VA Intervention

According to a February 4, 2010, “All VA Regional Offices Training Letter,” (10-01), with the subject, “Adjudicating Claims Based on Service in the Gulf War and Southwest Asia,”:

“The chronic disability patterns associated with these Southwest Asia environmental hazards have two distinct outcomes. One is referred to as “undiagnosed illnesses” and the other as “diagnosed medically unexplained chronic multisymptom illnesses” that are without conclusive pathophysiology or etiology. Examples of these medically unexplained chronic multi-symptom illnesses include, but are not limited to: (1) chronic fatigue syndrome, (2) fibromyalgia, and (3) irritable bowel syndrome.”

This letter preceded regulatory amendments and provided guidance to VA claims examiners to more appropriately adjudicate Gulf War veterans’ claims.


2014 VA Denial Rate of Gulf War Veterans’ Presumptive Claims

Data provided by VA to the office of then-Congressman Kerry Bentivolio on March 28, 2014 showed a nearly 80% denial rate for what VA termed in the response, “a Gulf War-related illness”. It appears that this is the cumulative VA denial rate of all presumptive undiagnosed illness and presumptive chronic multisymptom illness (Fibromyalgia, Irritable Bowel Syndrome; Chronic Fatigue Syndrome) claims by Gulf War veterans.

Key findings (2014)

  • 80% Gulf War Illness Claims Denial Rate. Of 54,193 Gulf War-related illness claims filed with VA, four out of five – nearly 80 percent (80%) – were denied.
  • 52% of the denied for something else. A full 52 percent of the denied Gulf War-related illness claims were approved by VA for something else, implying a VA bias against approving Gulf War Illness claims.
  • 38% denied for everything. A full 38 percent (38%) of veterans’ claims for Gulf War-related illness were had their claims denied entirely, both for Gulf War-related illness and other conditions.

By the Numbers (2014)

696,842 Veterans: The total number of veterans deployed to the Persian Gulf theatre of operations during the 1991 Gulf War.

54,193 GWI Claims: The number of Gulf War-related illness claims veterans have filed with VA, to March 2014. [VA notes this figure represents original claims for service-connection; it does not include reopened claims or claims for an increased disability rating.]

11,216 Approved: The number of Gulf War Illness claims that VA granted. [VA notes that due to data limitations, this figure does not include some Veterans who have been granted service connection on a direct basis (meaning that the disability became manifest during active service) rather than under the provisions of 38 C.F.R. § 3.317.]

42,977 Denied: The total number of Gulf War-related illness VA has denied.

20% Approved: The percentage of Gulf War-related illness that VA granted (11,216 approved out of 54,193 filed = 20.7%).

80% Denied: The percentage of Gulf War-related illness VA has denied (42,977 denied out of 54,193 filed = 79.3% denial rate).

22,470 Approved for Something Else: The number of veterans filing Gulf War-related illness claims that were denied but VA approved the veterans’ claims for some other condition(s).

42% Denied for GWI but Approved for Something Else: The percent of veterans filing Gulf War-related illness claims that were denied but VA approved their claims for some other condition(s) (22,470 approved for something else out of 54,193 total Gulf War-related illness claims filed = 41.5%).

52% of the Denied were Approved for Something Else: The percent of denied Gulf War-related illness claims approved for some other condition.   (22,470 approved for something else out of 42,977 denied Gulf War-related illness claims = 52.3%)

20,507 Denied for all Conditions: The number of veterans filing Gulf War-related illness claims that were denied for GWI and not receiving compensation for other conditions. (54,193 Gulf War-related illness claims filed minus 22,470 claims approved for something else = 20,507)

38% Denied for all conditions: The percent of all Gulf War-related illness claims filed that were denied for Gulf War-related illness and also not receiving compensation for other conditions (20,507 denied out of 54,193 = 37.8%)

67% Average Disability Rating: The average disability rating granted by VA for Gulf War-related illness claims filed.


VSO Response to 2014 Denial Rates  

In a July 16, 2014 letter from two of the largest veterans service organizations (VSOs), AMVETS and VVA, to then-Acting VA Secretary Sloan Gibson highlighted the newly released VA claims denial information and provided insight into why this was being allowed within VA:

“VA acknowledges that 250,000 suffer from Gulf War illness. (The recent VA ‘Gulf War Review,’ for example, states that nearly 700,000 U.S. troops deployed to the 1991 war and that VA’s major 2005 study showed that 37% of those (roughly 250,000) have chronic multisymptom illness, VA’s term for Gulf War illness. The 2010 report of the Institute of Medicine also found 250,000 veterans were ill and that their illness was associated with Gulf War service.

“Yet, VA’s own most recent statistics, provided in response to a Congressional inquiry this Spring, show that only 11,216 Gulf War-related illness claims have been granted and 80% of such claims are denied. (See VA report to Congressman Bentivolio, attached.) Even including all claims approved for other conditions, the total number of Gulf War veterans approved for care and benefits is only 36,000, out of the 250,000 afflicted.

“VA hides that damning fact in its official statements. The April 2014 VA Gulf War ‘Fact Sheet’ states that “currently, nearly 800,000 Gulf War era Veterans are receiving compensation benefits for service-connected issues.” What VA doesn’t say is that their definition of the ‘Gulf War era’ includes every veteran who has served from 1990 to the present, not just 1990-1991 Gulf War veterans. (See Fact Sheet attached.)

“Recent statements by Undersecretary for Benefits Allison Hickey provide the answer why VA is hiding this information. An April 22, 2014 article in Military Times reported that she was concerned that even using the term ‘Gulf War illness’ ‘might imply a causal link between service in the Gulf and poor health which could necessitate legislation for disability compensation for veterans who served in the Gulf.’ And on December 13, 2013, she testified that VA would be able to meet its 2015 goal of processing claims within 125 days, barring ‘something like we experienced in Agent Orange [when we added] 260,000 claims in our inventory overnight in Oct. 2010. That will kill us.’”


Recent Rates of VA Denial of Gulf War Veterans’ Presumptive Claims

Despite the latest VA intervention in 2010, the rate of denial of Gulf War veteran presumptive claims has been steadily worsening, year by year, as showna by data provided by VA for fiscal years 2011 through the first half of 2015. These claims include two types: chronic multisymptom illness claims (Fibromyalgia; Irritable Bowel Syndrome/Functional Gastrointestinal Disorders; Chronic Fatigue Syndrome); and, undiagnosed illness claims authorized under 38 U.S.C. 3.317.


1.  VA Denials of Presumptive Chronic Multisymptom Illness Claims

The rate of denial of Gulf War veteran presumptive chronic multisymptom illness claims (Fibromyalgia; Irritable Bowel Syndrome/Functional Gastrointestinal Disorders; Chronic Fatigue Syndrome) has been steadily worsening, year by year. By the first half of FY15, VA was denying these claims at a rate of nearly four-out-of-every-five.

FY2011:                      72.5%

FY2012:                      72.1%

FY2013:                      75.3%

FY2014:                      77.0%

FY2015 Q1, Q2:       79.2%

“CMI = Chronic Multisymptom Illness (fibromyalgia 5025, IBS 7319, and chronic fatigue syndrome 6354) in either the hyphenated or primary code. If condition is both UDX and CMI, it is included in UDX counts.”

(G) = Total Conditions Granted (“Vets”)

(D) = Total Conditions Denied (“Vets”)

(T) = Total Conditions Granted or Denied (“Vets”)


Formulas: (G) + (D) = (T);   (D)/(T) = denial rate

FY2011: 743 (G) + 1,961 (D) = 2,704 (T); 1,961 (D) / 2,704 (T) = 72.5% CMI denial rate

FY2012: 1,114 (G) + 2,877 (D) = 2,704 (T); 2,877 (D) / 3,991 (T) = 72.1% CMI denial rate

FY2013: 1,638 (G) + 5,002 (D) = 2,704 (T); 5,002 (D) / 6,640 (T) = 75.3% CMI denial rate

FY2014: 1,300 (G) + 4,341 (D) = 2,704 (T); 4,341 (D) / 5,641 (T) = 77.0% CMI denial rate

FY2015 Q1,Q2: 746 (G) + 2,849 (D) = 2,704 (T); 2,849 (D) / 3,595 (T) = 79.2% CMI denial rate


2.  VA Denials of Presumptive Undiagnosed Illness Claims

VA’s denial of Gulf War veteran presumptive undiagnosed illness claims is at even higher rates than VA’s denial of presumptive chronic multisymptom illness claims.


The rate of denial of Gulf War veteran presumptive undiagnosed illness claims has also been steadily worsening, year by year. By the first half of FY15, VA was approving only 14.7 percent of these claims – approaching the limited odds of winning a scratch-off lottery.


FY2011:                      80.5%

FY2012:                      78.4%

FY2013:                      78.6%

FY2014:                      83.1%

FY15 Q1, Q2:           85.3%


“UDX = Undiagnosed Illness, defined as diagnostic codes containing 88xx in either the hyphenated or primary code.”


Formulas: (G) + (D) = (T);   (D)/(T) = denial rate


FY2011: 480 (G) + 1,977 (D) = 2,457 (T); 1,977 (D) / 2,457 (T) = 80.5% UDX denial rate

FY2012: 628 (G) + 2,278 (D) = 2,906 (T); 2,278 (D) / 2,906 (T) = 78.4% UDX denial rate

FY2013: 925 (G) + 3,402 (D) = 4,327 (T); 3,402 (D) / 4,327 (T) = 78.6% UDX denial rate

FY2014: 627 (G) + 3,086 (D) = 3,713 (T); 3,086 (D) / 3,713 (T) = 83.1% UDX denial rate

FY2015 Q1,Q2: 339 (G) + 1,970 (D) = 2,309 (T); 1,970 (D) / 2,309 (T) = 85.3% UDX denial rate


3.  VA Denials of Gulf War Presumptive Claims (Chronic Multisymptom and Undiagnosed Illness Combined):


FY2011:                      76.3%

FY2012:                      74.7%

FY2013:                      76.6%

FY14:                          79.4%

FY2015 Q1, Q2:       81.6%


Formula: [(CMI D) + (UDX D)] / [(CMI T) + (UDX T)] = denial rate


FY2011: [1,961 (CMI D) + 1,977 (UDX D)] / [2,704 (CMI T) + 2,457 (UDX T)] = 76.3% CMI+UDX denial rate

FY2012: [2,877 (CMI D) + 2,278 (UDX D)] / [3,991 (CMI T) + 2,906 (UDX T)] = 74.7% CMI+UDX denial rate

FY2013: [5,002 (CMI D) + 3,402 (UDX D)] / [6,640 (CMI T) + 4,327 (UDX T)] = 76.6% CMI+UDX denial rate

FY2014: [4,341 (CMI D) + 3,086 (UDX D)] / [5,641 (CMI T) + 3,713 (UDX T)] = 79.4% CMI+UDX denial rate

FY2015 Q1, Q2: [2,849 (CMI D) + 1,970 (UDX D)] / [3,595 (CMI T) + 2,309 (UDX T)] = 81.6% CMI+UDX denial rate



VA Intervention: Amending the M21-1

It appears that VA has made a new intervention by amending the M21-1 “Veterans Benefits Manual,” which is supposed to be used for rating VA claims. However, it is not clear whether VA rating staff are aware of, let alone utilizing this manual to rate Gulf War veterans’ claims.

With no new Gulf War claims data released since the second quarter of FY15, it is unclear whether this intervention has had any positive effect on improving VA’s terrible denial rates for Gulf War veterans’ UDX and CMI claims.

Given VA’s past record, it is unclear whether this latest intervention will be just one more in a long line of ineffective “solutions”. Past VA “solutions” have done nothing to quell VA’s extraordinarily high denial rates of these veterans’ claims.



Claims Denial Conclusions

In short, VA’s denial rates for Gulf War UDX and CMI claims remained high over time. In recent years, VA’s denial rates have been increasing for these Gulf War veterans’ claims.

This is in complete contravention to the intent of the 1998 laws passed to improve Gulf War veterans’ ability to get their claims approved, while prioritizing treatments was made an even higher priority – but not by VA.



VA Needs to Track, Analyze, and Regularly Report VA Utilization Data for 1990-91 Gulf War Veterans.

In 2010, VCS Director Paul Sullivan testified, “In 2002, VA staff conducted a thorough review of granted and denied claims among Gulf War veterans at the diagnostic code level.  VA staff concluded that VA regional offices with large claim backlogs and without training on UDX claims under 38 CFR 3.317 approved few (about 4 percent) of Gulf War veterans claims.  In contrast, VA regional offices with small backlogs that received training from VA Central office approved far more UDX disability benefit claims (about 30 percent).  At present, VA has no idea how many UDX claims have been granted or denied.”
Today, it is unclear whether VA is consistently tracking UDX claim denials and approvals. Certainly, VA is not publicly reporting that data, at least not in any way that is regularly and readily accessible to Gulf War veterans or the veterans advocacy community.

VA must return to the regular public reporting of carefully collated and analyzed Gulf War veterans’ claims and VA usage data.

VA must return to the regular public reporting of carefully collated and analyzed Gulf War veterans’ claims and VA usage data.  VA must be held accountable for its actions, and without easy public access to this VA data, accountability will remain difficult to achieve.



If we measure VA’s success by how it has approved Gulf War veterans’ claims twenty-five years after the war, VA has failed most ill and suffering Gulf War veterans. VA has circumvented or ignored most of the aims of the 1998 laws. Despite various high-level interventions by VA to improve the claims process, the denial rates remain unacceptably high and are getting worse each year.

In twenty-five years, VA has made little progress in finding effective, evidence-based treatments for Gulf War Illness, denied Gulf War veterans disability claims nearly across the board, and relegated these veterans to the realm of mental health interventions.

VA has the authority to develop new presumptives for these ill and suffering veterans, but unlike with Agent Orange, has failed to identify any new conditions beyond a set of rare endemic infectious diseases that affect almost no one. The latest report by the Institute of Medicine, shaped by VA’s contract, argues that individual Gulf War exposures are forever unknowable. We knew that when seeking the 1998 legislation, aimed at connecting generic exposure data with health outcomes. VA has stymied those efforts.

Twenty-five years later, ill Gulf War veterans are still in pain. They are suffering. They have been begging for help for years and years. As I noted in my February 23 testimony, the letter, the spirit, and the intent of the 1998 Persian Gulf War laws have yet to be achieved.

On this 25th anniversary of the war, our Gulf War veterans are still waiting for VA to provide effective, evidenced-based treatments for Gulf War Illness. Given their level of disability, the least we can do is to cause VA to approve their presumptive, service-connected disability claims.

Please help fix these serious issues, once and for all.





Public Law 102-1, enacted in January 1991, authorized the President to start the Persian Gulf War, known at the time as Operation Desert Shield and Desert Storm.  Offensive U.S. military action against Iraq began on January 17, 1991 local time (the evening of January 16 in the United States).

Public Law 102-25, enacted in April 1991, retroactively established the start date of the Gulf War as August 2, 1990, the date Iraq invaded Kuwait.   Neither Congress nor the President have ever ended the Gulf War, and the conflict continues through to the present. According to 38 CFR 3.317(e)(2), “The Southwest Asia theater of operations refers to Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. (Authority: 38 U.S.C. 1117, 1118).”

 Public Law 102-85, enacted in November 1992, authorized the creation of the Gulf War Registry as well as the Gulf War Veterans Information System (GWVIS).  VA began preparing GWVIS reports in 2000, and VA ceased producing the reports in 2008 after VCS observed that VA’s GWVIS reports were incomplete.  VA has since confirmed that it failed to update computer programming to identify all disabled Gulf War veterans.

Public Law 103-210, enacted in December 1993, required VA to provide healthcare on a priority basis (Priority Group 6).

Public Law 103-446, enacted in November 1994, expanded access to VA disability benefits so ill Gulf War veterans could obtain VA medical care under for the undiagnosed illnesses.  The law included a long list of toxins to which Gulf War veterans were presumably exposed, including depleted uranium, fumes and smoke from military operations, oil well fires, diesel exhaust, paints, pesticides, depleted uranium, infectious agents, investigational drugs and vaccines, indigenous diseases, and multiple immunizations.

Public Law 105-277, enacted in 1998, significantly expanded the list of toxins it presumed Gulf War veterans were exposed to during deployment to Southwest Asia, and mandated contracts between VA and the National Academy of Science (which ultimately was conducted by NAS’s Institute of Medicine (IOM)) to determine association between Gulf War exposures and Gulf War veterans’ health conditions.

Public Law 105-368, enacted on Veterans Day 1998, expanded Public Laws 103-210 and 103-446. It also directed the creation of the the Research Advisory Committee on Gulf War Veterans’ Illness (RAC), which VA failed to create the RAC until 2002 – more than three years after the statutorily mandated deadline.


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House Veterans’ Affairs Chairman Lambastes VA’s Latest Accountability Failures

WASHINGTON — Today House Veterans’ Affairs Committee Chairman Jeff Miller (R-FL-1) released the below statement following VA’s announcement that no employees will be seriously disciplined for the biggest construction failure in VA history as well as a separate $400,000 relocation scandal.

“Nearly every day we are reminded that accountability at the Department of Veterans Affairs is almost non-existent. Today’s announcement from VA that no one will be seriously disciplined for wasting more than $1 billion on a failed construction project and that a few executives might receive a weak slap on the wrist or a temporary written warning for a relocation scandal that cost taxpayers more than $400,000 is more proof of this sad fact. One thing is clear: this dysfunctional status quo will never change until we eliminate arcane civil service rules that put the job security of VA bureaucrats ahead of the veterans they are charged with serving. The House acted to do just that last summer with passage of the VA Accountability Act, which would give the VA secretary the authority to swiftly fire or demote any VA employee for poor performance or misconduct while protecting whistleblowers and limiting the agency’s ability to place misbehaving employees on paid leave. If the Senate doesn’t follow suit with similar legislation to do the same thing, it is illogical to think VA’s many problems will ever be fixed.” – Rep. Jeff Miller, Chairman, House Committee on Veterans’ Affairs


VA Can’t Fire Employee Involved in Armed Robbery Because of Other Criminals on Payroll

After Employee is Charged with Killing Veteran, VA Pays $215K Settlement But Fires No One

VA didn’t fire nurse who participated in surgery while drunk

Instead of Disciplining Bad Docs, VA Pays Them to Do Nothing, Restricting Vets’ Access to Care

VA Doesn’t Fire Heroin-Dealing, Cocaine-Abusing Employees

Top VA Official Admits It’s “Almost Impossible” To Discipline Most VA Employees

*SOURCE:  Press Release, U.S. House of Representatives, Committee on Veterans’ Affairs, March 23, 2016.

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