Health Care for Exposure to Military Environmental Hazards

Part II: Environmental Exposure Claims and Senate Bill S.3378: Good Try but Not a Winner.

(WASHINGTON D.C.) - Most Americans would agree that those injured in the military are entitled to health care to heal their bodies.

For those injured by exposure to radiation or toxic chemicals, the latency in the onset of disease can take years after separation from the military.

Even if a veteran can “connect the dots,” it may be virtually impossible to prove service connection or, at the very least, a costly effort to meet the “at least as likely as not” threshold required by the VA.

Senator Daniel Akaka, (D, HI), Chairman of the Senate Veterans’ Affairs Committee, sponsored S.3378, requiring scientific evaluation of environmental exposure claims. However, like most bills, ‘the devil’ is in the details.

On January 28th, the Senate Veterans’ Affairs Committee voted 9 to 5 along party lines in favor of the bill. The bill was posted to the Senate Legislative Calendar last week.

If environmental exposures are substantiated by scientists, veterans and their dependents would be eligible for government health care. Hold up on cashing your checks. The final decision would be made by DOD and the VA.

The bill does not provide for a monthly compensation award, only government health care. Veterans with current disabilities linked to environmental exposures would still be required to file VA disability and compensation claims under Title 38.

Even so, for many veterans and their families injured from contaminants and out of work, access to health care may be literally a life saver.

The Committee Report for the bill states that the intent is to review a ‘specific cohort’ of people at a military installation, and not to ‘adjudicate’ individual claims.

Even if the bill becomes law, hold up on putting together an individual claim; the bill’s focus is looking at potential environmental exposures at a military installation or an area within an installation.

Based on the 130 military bases on the National Priority List (EPA Superfund), there’s more than enough work for a group of independent scientists authorized by this bill.

The idea is that a group of independent scientists would provide a fairer approach to determining health care benefits or compensation then the current piecemeal system. At least that’s the theory and the stated hope of the Senator Akaka and the Senate Veterans’ Affairs Committee.

Unfortunately, the bill limits the scientists to an information gathering role, leaving the DOD and VA to make the health benefit award decision. If you believe that DOD and the VA will make these decisions on the scientific merits only, you are more naïve than me.

The bill defines a ‘military exposure’ as exposure of an individual to an environmental hazard on a military installation, except for an installation where imminent danger pay is authorized. For example, exposures to chemicals, radiation and environmental hazards in a war or conflict zone (e.g., Iraqi and Afghanistan) are not covered by this bill.

The Advisory Board’s mission is “to consider and study cases of exposure” of current and former military and their dependents to potential environmental hazards at military installations.

The bill provides authority to the Secretary of Defense and the Secretary of Veterans Affairs to jointly establish the ‘Advisory Board on Military Exposures.’

The requirements are: 2 members are from Veteran Service Organizations, 2 from federal agencies other than DOD and the VA and the remaining 3 must be scientists with backgrounds in environmental exposure or environmental exposure assessments, health monitoring, or other relevant fields. Board members serve for 3 year terms, but not longer than 6 total years.

The ‘grunt work’ of the Advisory Board will likely be done by its Science Advisory Panel, a group of 7 scientists with backgrounds in environmental exposure or environmental exposure assessment, health monitoring, other relevant fields.

The Advisory Board and the Science Advisory Panel have subpoena authority to require testimony of witnesses. They will need it. A great deal if not most of the information on environmental hazards on military installations is resident in DOD databases or in dusty file cabinets.

In commenting on DOD’s response to the Committee’s hearing on Camp Lejeune’s water wells, Senator Akaka noted that, “elements in the Department of Defense have been less than forthcoming.”

There’s no reason to expect DOD to ‘roll over’ and fully cooperate with a group of independent scientists. You can get better odds in playing blackjack. The subpoena authority will be an especially useful too.

For this process to work equitably, the Advisory Board and the Science Advisory Panel must be independent of influence from DOD, the VA, and industry.

DOD and the VA have input into the 3 scientists on the Advisory Board. You can be assured that these scientists will have a friendly track record with these agencies, especially DOD. The Advisory Board, in turn, selects the 7 scientists on the Science Advisory Panel. Unless some special efforts are taken to ensure independence, all or the majority of the scientists could easily have a bias towards DOD.

The bill requires that the Advisory Board be appointed by the President in consultation with DOD and the VA. DOD and VA officials are specifically excluded from membership. However, the major drawback is that DOD and the VA jointly establish the Advisory Board and are actively involved in the selection of the Advisory Board’s membership. It’s obvious that the personnel recommended to the President by DOD and the VA will be supportive of their interests.

The bill requires that the Executive Director of the Advisory Board be a civilian employee of DOD. This provision is highly questionable. DOD’s hostility to accepting responsibility for the health effects of environmental exposures was demonstrated in the recent Senate Veterans Affairs Committee’s hearings. There’s no critical need for this person to be a DOD employee and specifically excluding employees of DOD and VA from this position helps to reinforce the independence of the Advisory Board and just makes good common sense. Why ask for trouble?

The Advisory Board can only make recommendations to the VA and DOD to provide health care benefits. The bill gives authority to approve federal health benefits to the VA and DOD.

Limiting the authority of the Advisory Board to an information gathering role puts DOD and VA in the driver’s seat. This may not be comparable to the fox in the hen house, but it’s a close second.

The decision to provide health care benefits to injured veterans and their dependents should be a fair and impartial one—one that is solely based on scientific evidence. Not political clout or budgetary constraints.

The Congressional Budget Office estimated that 20,000 former Lejeune and Atsugi personnel would be approved for health benefits (out of a population of 675,000). CBO estimated an additional 100,000 claims approved by the year 2020 for the remaining military installations.

The Committee report questioned CBO’s estimates and made special mention that the role of the Advisory Board is to gather information only, not to make awards. The Advisory Board “has no power to provide benefits—health care or monetary—to any individual.”

There are 130 military bases on the EPA National Priority List (EPA Superfund). These bases are among the most toxic and hazardous sites in the country. Most if not all of these bases should be candidates for evaluation by the Advisory Board.

The widespread use of chemicals needed to support the military mission (e.g., jet fuels and degreasers like TCE), unsafe disposal practices, and failure to use personal protective clothing and equipment have lead to environmental contamination and unnecessary human suffering.

EPA’s Superfund database lists the Contaminants of Concern (COC) for all of the 130 military bases on the NPL and the potential health effects of exposure to them. EPA defines COCs as chemical substances which pose an unacceptable risk to human health or the environment.

Under the bill, individuals would be eligible for government health care or compensation whenever the Advisory Board finds that they “were exposed to sufficient amounts of environmental hazards to warrant health care or compensation.”

The fact that EPA identified substances which pose an unacceptable risk to human health on a military installation does not give a veteran or dependent a free pass to health care or compensation.

If this were the case, every veteran and dependent with service on an EPA Superfund site would automatically be eligible for health care or compensation. The key factor is evidence of exposure.

Dermal contact, ingestion, and inhalation are the three routes of exposure to contamination. Evaluation by scientists with backgrounds in environmental exposure or environmental exposure assessment, health monitoring or other relevant field would be required to determine whether health effects experienced by individuals are linked to military service. It makes sense that the work of these scientists be the basis for rejection or approval of health benefits. The bill gets an “A” for relying on scientists to evaluate the potential exposures but a “F” for passing the decision to DOD (the polluter) and the VA.

Millions were spent and continue to be spent by DOD in remediation work at EPA Superfund bases. There is no requirement to notify veterans and their dependents of the environmental hazards they may have been exposed to and the health effects. Most veterans are frankly in the dark, unable “to connect the dots” of their illnesses to military service.

There is no provision in the bill to notify veterans of any of the EPA Superfund bases of the contaminants (read “environmental hazards”) they may have been potentially exposed to and their health effects.

Based on my limited review, I found this information available from the EPA Superfund database, which links contaminants to health effects on the ATSDR database.

It’s not a secret, but our government has not gone out of its way to inform individuals of the harmful contaminants they may have been exposed to. For one, this information would be useful to a medical care provider and may be a critical life saving piece of data. Why not pass the information on to the veterans’ service organizations, asking them to alert their memberships?

For the very few veterans who have managed to “connect the dots of military service to illnesses,” it is an expensive and uphill fight to obtain government health benefits and compensation. For their dependents, the outcome is even bleaker. The only option for a dependent is to file a Federal Tort Claim. There’s no data on the number of tort claims filed by dependents, but you can bet, it’s unlikely to be many. If you’re in doubt, search the internet for a copy of SF-95. If you like doing income taxes, you’ll love this form.

The bill’s focus on scientific evaluation of environmental hazards on military installations is an excellent start. However, using scientists to gather the information and make the evaluations but not made the award decisions is a mistake.

By limiting the Advisory Board’s role to information gathering, the bill, in my opinion, misses the target. The real decision makers are DOD and VA and they have indicated little willingness to support health care for those affected by environmental exposures.

As a veteran, that’s good enough reason for me to not support the bill without substantial changes in the role of the Advisory Board and its scientists.

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Comments Leave a comment on this story.

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Dan Sullivan June 1, 2010 4:24 am (Pacific time)

Editor: Check your facts on the Ken Starr comment below; you are wrong.

Editor: Dan, thanks.

Anonymous May 29, 2010 11:35 am (Pacific time)

King you wrote: "And if you are a VN Vet, it is sad that you turn so hard on a fellow VN Vet. It isn't how I normally see it go, except for a friend or two over the years involved in the POW situation, who hate Kerry for what he and McCain did to the League of Families." So tell me moron, what did Kerry do to his so-called war veterans? God your such an idiot! How about Jack Murtha? God hope he is burning in hell, with many like him soon to join the mfing bastard.

Tim King: You would be such a nice guy if I was standing in front of you, you would stand there and not rant any of this. you wouldn't call me stupid, because that's how you guys are, little nameless wonder, and you know better. So you were in Vietnam? I doubt it and you were some little admin paper pusher at best. You don't have the right to even talk about Combat Vets you disrespectable SOS.

Juan Santiago May 27, 2010 7:25 pm (Pacific time)

I'm amazed how some people think that we Vietnam combat veterans who dislike Kerry do so without reason, or that it is based on ideology. It is based on his past behaviors, and his incredible lies to congress and to the media going back nearly 40 years ago. I know several Swiftboat vets who served with Kerry, they have their opinions based on their interactions, and people like me formed our opinions on his actions and lies over the years. Have you ever talked to POW's who were being held by the North who played back Kerry's lies to them? Or vets like me who on numerous occasions found ourselves having to deny Kerry's false charges? That is we committed war crimes as a matter of routine SOP. Needless to say all veterans are individuals and we all come with our opinions, but back in the day when we were in combat we were one for all and all for one. Kerry was not bonded to his fellow men, he angled how to leave early and he did after around 4 months with his 3 bandaid wounds. Now I'm not associated with any political party, nor any hispanic organization, hell I can barely speak spanish, but to all those I associate with who served with me, we all have utter contempt for Kerry. In regards to past wars, then maybe a review of who was in office and their political party when WW1, WW2, Korea and Vietnam started. In the latter two wars, who was in office when hostilities ceased? Also the entire congress, all parties, okayed the conflicts we are currently involved in and they continue to provide funding. I also do volunteer driving running vets to the local VA hospital, so I get into many conversations with vets of all ages and experiences, so I do hear a steady stream of opinions, and people like Kerry don't generate much support for his past and current behaviors. The VA healthcare system has been hurting for decades, it is the 2nd largest government system in America, right behind the DOD, so things run very slow. I don't expect things to improve, but it would be an excellent idea to have 100% disabled vets provided with private, and fully paid insurance so they can get help in their home areas. It is really sad to see vets in their 80's and 90's having to travel for hours , and then wait for hours to get treatment when medical facilities are available near where they live. Same goes for any disabled vet, but the elderly ones having to make these long treks really breaks my heart.

Tim King: First, why are you showing up under different names Wade? Immediately it looks like you are fiction.

What do you think about McCain? I know a Marine who caught NVA moving film canisters through the jungle. They killed the North Vietnamese and looked at the developed film, later, after getting back to their firebase. Who was there but John McCain giving confessions.

Now, are you going to try to suggest that John Kerry's testimony about some of the atrocities taking place in that extremely unpopular war are not true? You can't rewrite history, it is well documented and our reporter Chuck Palazzo just attended the anniversary at My Lai and we know the deal, and we know about the deeds of Bob Kerry, I can't believe he's still showing up on TV shows. Where is the rant about him?

So, most everyone in VN was honorable, but the percentage if you consider the Pinkville incident, was pretty friggin' bad at times, worse by far toward the end; another fact. You can't change that, but you don't have to wear it either.

And if you are a VN Vet, it is sad that you turn so hard on a fellow VN Vet. It isn't how I normally see it go, except for a friend or two over the years involved in the POW situation, who hate Kerry for what he and McCain did to the League of Families.

As far as Veterans I know and have talked to, the last one who told the POW story was a fraud. The same day a guy (in my video damn it) claimed to be from Navy SEAL Team 2 and he was a fraud too, both exposed to me by the groups that represent the real interests of these Veterans. I spent half a day with Jim Rassman who John Kerry pulled out of the Mekong River.

Again, where is the criticism for Bush who just got thousands of Americans killed for no reason and hundreds of thousands damaged with injuries and PTSD? Where is it Juan Santiago? Since we are talking about an issue involving credibility, I need an email from you in order for this to continue. There is a clearly stated policy in our rules about not posting under different names, I know multiple people can use the same computer, but your writing is a match under both names. Clear it up if you want to show up here: tim@salem-news.com. Thanks.

Juan Santiago May 27, 2010 12:24 pm (Pacific time)

Obama, like LBJ, Carter and Clinton, were/are held in contempt by the majority of active duty military and veterans. Every poll out there verifies. Back in 2004 when John Kerry came to address my veteran's organization national meeting in Las Vegas, most of us stood up and turned our backs to him, and many walked out. This had nothing to do with the Swiftboat personnel who hated this rich coward, but what he said about Vietnam vets. We veterans across the country were the critical votes that beat this racist liar, John Kerry Kohn. Some clown who spent 3 months in a cushy job, not knowing what combat really was, much less having served deep in-country. As it is, when Obama, who is ignoring the military leaders, including the commander of the Marine Corp, not to change the "Don't ask don't tell" policy. He is attaching it to a defense appropriation bill next week. The military study will not be finished till December. So what's the rush? Yeah, let's ignore the professionals and let's take some people who never served in a combat unit, much less the military and have them decide. So what branch of the service was Obama in, or any of his immediate staff, uno, the ones from Chicago and Harvard? Obama wanted service-connected vets to use their private insurance to pay for VA medical treatment, until he felt the wrath of the veteran anger. His staff labels all vets as potential right wing terrorists. Oh yeah, he's just tops to us real combat vets. We will defeat him, and he will leave feeling the contempt of all clear thinking Americans. In fact right now the majority of voters absolutely cannot stand this con man , just look at the polls. You who hate Bush, have no idea of the hate out there for Obama, and it is growing by the minute, and it is real hate!

Tim King: First, maybe I'm to blame for taking this off topic, but we'll be using this thread to talk about Marines and breast cancer and Camp Lejeune, that's what it was for. I don't believe I have ever met a person who served in combat, to slight another one that way. But the hipocracy; tearing up a person who really was there, that one gets me. You would have the world believe all veterans are a bunch of extreme right wingers but that isn't the case. Just look at this team, one combat veteran after another and while they all respect those who serve, there's not a single one who is missing the point that Republicans start wars, and Democrats end them. John Kerry was rich, and he didn't evade the war like EVERY SINGLE LOUD REPUBLICAN like Bush and Cheney and Rumsfeld and Rove and Limbaugh and O'Reilly and Savage and Dobbs and... The last one I remember was Bob Dole and he's funny and easy to not dislike, even it his politics are dead opposite of what they should be. There is a nasty evil quality to a repub slamming a war vet, I admit it bothers me. Kerry's problems are tied to the POW/MIA issue, but you didn't even mention that.

Bob Doig May 27, 2010 11:39 am (Pacific time)

fellow and honored vets, every conflict,action, call it what you want, even war, have all been the result of policial greed. Caused by politians and fought and died for by proud and great american men and women. On the subject of Bill Clinton- I have a problem with him having the title of Commander and Chief of the Armed Forces- yes he was a draft dodger, and my other problem is that he still receives all his benifits as a former President even after he was impeached. Every former servicemember was lied to in writing on their intitial service contracts- full medical care and dental was promised to us all for life. A small price to pay for putting our lifes on the line 24/7 for freedom for all. Unless you were in service, know someone who was/is- there is no informed imformation of what Hell we and our family members went through for our country. God bless one and all.

Editor: Did you hear about Ken Starr getting arrested? Boom! Finally, the crook who spent tens of millions of dollars taking down our President for a BJ is now rotting behind bars, there is a small amount of justice in the world. Clinton gave and gave to the Republicans and for a while i thought for sure he was one, but then I value things like peace, a strong economy and a President who has Fleetwood Mac play at the Inaugural Ball.

Van May 27, 2010 10:21 am (Pacific time)

Anonymous-You judge me wrong, that wasn't a political statement just the facts. The Bush admin didn't do what was needed when going into these wars, period. There were no surprises. When you make wars , you make veterans that are sick. You plan by increasing the funding first. Once funded you hire. Viet Nam and Gulf War vets are sicker than the general population and it's been that way for a long time. The previous admin ignored this. These veterans are as much of a surprise as the banking collapse was. Both have been coming on for many years and were ignored by all of our politicians. I might suggest you read SR103-97, the ancillary, interim and Final Reports 1 and 2. They've been out there for years. They discuss why veterans are sick. The causes are war and how we make war for starters and the illegal and immoral experiments. The way the military has done things is under the guise of soverign immunity and the Feres Doctrine. This has resulted in the exposure of our armies to the most toxic substances created by science. And the exposures came whether you were in combat or not, peacetime or wartime, incountry or outside. The DoD and our government have shown nothing but willful ignorance and have allowed many veterans to die. Studies are falsified, agencies are prevented from getting at the truth by way of underfunding. Protocols are ignored, science is altered, dodge studies meant to waste time resources while looking away from the most likely culprit or the direction the evidence points. Anonymous you must be ashamed of your opinions, that's why you remain Anonymous. Ideology is killing America no matter what side.

Anonymous May 26, 2010 6:30 pm (Pacific time)

I'm a service-connected Vietnam vet, and it's always been the pits dealing with the VA, but it was LBJ who really failed to get the funding for us right from the jump. Then later during Clinton, we actually had a reduction in medical services on a per capita basis because of a huge influx on new patients that we did not have enough funding for nor enough medical staff. If you go do the research, you will see that the Bush Administration increased funding beyond the inflation rate during the entire time he was in office. I try not to let politics come into play when it deals with veterans, but Van, you have no evidence other than your obvious political agenda to misinform, in my opinion, which is based on facts. The current administration has failed to get the medical staff we need into the VA system, so all the money in the world means jack. This Obama and his non-veteran staff, mark my words, will prove to be an anathema to us vets.

Editor: Well Bush already proved to be one, and he left this nation in shambles, we're on our way toward becoming the homeless bum on the street corner of nations. So here comes this guy who isn't out for the richest 2% but for the people at large, why single out Obama? I'm just curious, that last SOB is so pathetic that it makes me just shake with anger, toward all of the broken people sent to a BS war that never ever should have happened. But a spoiled blue-blooded Texan's ego cost that one, and I don't hear a word about that. Believe me Bush doesn't give a rip about you and me, Obama however does things that indicate that he does. I know this nation is full of people unable to see things right in front of them, but in my book anyone against my fellow American having healthcare is a sad person. God help us.

Van May 26, 2010 8:42 am (Pacific time)

The biggest setback to VA healthcare is the underfunding by all admins until now. The worst being the Bush admin. They underfunded the DVA every year, even though we were taken into two wars. This admin instead gave taxcuts to the very wealthy. Never before have we gone to war without raising taxes to pay for it. Then Bush ignored the looming problem of sick Viet Nam vets and the Gulfwar vets. This wasn't brain surgery, you go to war you tax to pay for it, you take care of veterans that are made sick. You do this by fully funding the DVA and by paying attention to history. This article is about the contamination to military personnel during service. It has gone on for a long time and the DoD and DVA and each subsequent admin have ignored the problem allowing many of us to die. Some admins like the Reagan era did the most damage to us Viet Nam War vets because they were willing to compromise the science, falsify it. It's a breath of fresh air to have an admin now fully fund DVA. They've also had the guts to expand healthcare to our incountry Viet Nam vets with the 3 new presumptives. But that isn't far enough and hopefully this bill will ease the burden on all sick veterans made sick in service. I don't see it happening because of the history of our government, DoD and DVA. They have never taken responsibility for their actions. They'd just like us used up vets to die. We're a burden to these greedy sob's. One thing I do know is they'll have a war some day and we won't be there for them. If the article is right this is nothing other than smoke and mirrors and I don't expect anything from it. I do expect things to go on as usual. The fix is already in, just read the article and forget about Clinton and your ideology. We're in this together.

Jess May 25, 2010 10:29 am (Pacific time)

Luke Easter, Bill Clinton did not go to Canada to evade the draft, but he did go to Red Square in Moscow Russia in 1968 to protest the Vietnam War. He was 22 at that time. I was a bit older, and in Vietnam at that time finishing my second tour there. I had no problems with many childhood friends, including those I did my undergraduate degree with prior to my going to Vietnam, who continued to get deferments. Those who criminally evaded the draft, regardless of Carter's later pardon, I have always held in contempt. We combat veterans are very grateful that Clinton did not serve, it takes a lot more than the "gift of gab (glibness)" to lead people in combat, or to follow others lead. I would like to add Luke, that if you are service-connected, then your quality of healthcare did get adversely impacted by Clinton's short-sighted policies with the VA. Let's say you are 100% service-connected, then prior to Clinton, you had priority for medical care. Clinton increased veterans participation for VA healthcare, but did not fund it. For example, a vet who has no service-connection (there are many different levels of VA ratings for care) and they make an appointment for the same doctor/specialist you need to see, then you no longer have priority in this new Clinton scheme, you go to the back of the line. The waiting time continues to increase for service-connected veterans. The VA healthcare was designed primarily for service-connected veterans. Even with additional funding, it has not helped the situation, mainly because there are so many doctors and medical staff personnel available. Wait till 2014 when the Obamacare is expected to begin, then even less medical personnel available for the VA. Clinton is liked by many of you out there, but he sure hurt the VA healthcare system, but most non-veterans are pretty much clueless about veterans needs, or maybe they only act like they care during election season?

Daniel Johnson May 24, 2010 7:22 pm (Pacific time)

Luke: Your comment about Clinton going to Canada to avoid the draft is in error. His activities through that period are well documented. He was a Rhodes Scholar and studied at Oxford. He had an uncomfortable draft number so got a deferment through an alleged commitment to go into ROTC, which he never did. But it kept him out of the draft.

Luke Easter May 24, 2010 6:56 pm (Pacific time)

Bill Clinton went to Canada to escape the draft. Yet he still bacame President twice. I wonder how many not voting for the bill actually served in the military. BTW, Hawaii is not considered as serving overseas. One of the reasons I joined in 1970 was the "promise" of free health care for life. Little did I know it was only for the life of the bill that was in effect at that time. Soliders don't wait to put their lives on the line. Why should they have to wait for benefits rightly deserved, earned, acquired... You get the drift. And the band played on. Semper-Fi! Ooh-Rah

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