Shinseki Stopped Hearing to Cut Agent Orange Expansion

Honorable DVA Sec Eric K. Shinseki

By Tom Philpott

VA Secretary Eric Shinseki met with Sen. Daniel Akaka (D-Hawaii), chairman of the Senate Veterans Affairs Committee, last month to ask that he cancel a hearing on the secretary’s controversial decision to add three diseases to the list of Vietnam veteran illnesses presumed caused by exposure to Agent Orange and other herbicides used in that war.

Akaka reluctantly agreed, an informed source told Military Update. The VA thus avoided a brighter public spotlight, so far, on a decision that will help tens of thousands of veterans but also will add $13.6 billion to VA compensation claims in a single year.

Akaka and Sen. Jim Webb (D-Va.), a committee member, are pressing Shinseki outside of the hearing process to explain last October’s decision to add heart disease, Parkinson’s disease and B-cell leukemia to the list of illnesses presumed caused by Agent Orange.

Several weeks after their meeting, Akaka followed up on a March letter to Shinseki with a new one, this one asking the secretary for more details on the consequences of presuming service-connection for ischemic heart disease to any veteran who can show he stepped foot in Vietnam.

Katie Roberts, Shinseki’s press secretary, had no comment on whether the private meeting occurred. She did note in an e-mail that “VA’s primary mission is to be an advocate for veterans of all eras” and that “veterans who endure health problems as a result of their service deserve better.”

“Throughout the entire Agent Orange review process,” Roberts added, “VA has followed the rules created by Congress.

A spokesman for Akaka could not say “what was discussed in a personal meeting.” But the committee had schedule an April 21 hearing on Shinseki’s Agent Orange decision. At VA’s request that was reset to May 5. But the hearing topic changed again when VA refused to provide witnesses.

“Chairman Akaka remains concerned about the decision and still intends to pursue this matter in the committee,” said Jesse Broder Van Dyke. “The hearing could be rescheduled again in the late summer or fall.”

Veterans diagnosed with a presumptive Agent Orange disease can file for a service-connected disability rating and monthly compensation. Surviving spouses too can file claims, for dependency and indemnity compensation, if married veterans die of service-connected ailments.

VA issued an interim regulation in March for implementing Shinseki’s decision, even cutting the 60-day comment period in half. However, because of the large cost involved, Webb in late May attached an amendment to a war supplemental bill to prevent claims under the newly presumptive diseases from being paid until 60 days after a final regulation is published.

That final rule likely won’t be published until fall, at the earliest, but when claims can be paid they will be retroactive the date first filed.

Webb’s maneuver is to give Congress more time to study the science behind Shinseki’s decision and how the hefty cost — $42.2 billion over 10 years — could impact other VA services. It’s a particular concern for Akaka.

To stop the regulation from taking effect, both the House and Senate would have to pass a blocking resolution. Veterans’ service organizations say that is not likely to happen.

Some critics say Congress, in effect, abdicated its responsibility to stay atop these compensation issues when it passed the Agent Orange Act of 1991, giving the secretary authority to make presumptive disease decisions.

But Webb complained in a June 4 letter to Shinseki that the law was intended “to establish presumption of service connection for relatively rare conditions.” Instead, “presumptions have expanded to include common diseases of aging.” He noted that the VA secretary added prostate cancer to the list of Agent Orange diseases in 1996 and Type-2 diabetes in 2001.

Today, almost 10 percent of veterans who served in Vietnam are compensated for Type-2 diabetes, Webb said. Adding ischemic heart disease will be “a new dramatic expansion of disability compensation.”

Webb, like Shinseki, is a decorated Vietnam combat veteran. But on this issue he is being attacked bitterly through letters, e-mails and online chat rooms by ailing veterans who expected by now to be drawing VA compensation.

It was Webb, in his letter, who revealed that VA twice had declined to testify on Shinseki’s Agent Orange decision. It was another source who said Shinseki met with Akaka to ask that no such hearing be held.

In an April 26 letter, Shinseki advised Akaka that ischemic heart disease, also known as coronary artery disease, could generate 76,000 new claims this year and retroactive payment for 75,000 claims filed earlier. Another 41,600 heart disease claims are expected in 2011, VA calculated, and another 44,000 could be filed from 2012 through 2015.

Under the Agent Orange Act, VA hires the National Academy of Sciences’ Institute of Medicine (IOM) to review the latest scientific evidence that associates herbicide exposure to disease. An updated IOM report is issued every two years.

Akaka’s letter to Shinseki May 28 indicates it’s the decision on heart disease, the third most common illness among the elderly, that so concerns the committee. The IOM found “inadequate or insufficient evidence” of a link in 2006. In its 2008 update, IOM put heavier emphasis on studies showing a more rigorous tracking of exposure levels. Five of them showed a “strong statistically significant association.” So IOM switched ischemic heart disease from a category of “insufficient evidence” to “limited or suggestive evidence.”

Veterans waited months for Shinseki to act on the 2008 report. His decision, when finally made, delighted many Vietnam veterans. Akaka and Webb now want to learn a lot more about what went into that decision.

- Tom Philpott, a syndicated columnist and freelance writer, has covered the military for more than 25 years as senior editor of Navy Times. To comment, e-mail milupdate@aol.com, write to Military Update, P.O. Box 231111, Centreville, VA, 20120-1111 or visit: militaryupdate.com

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