August Disability Commission Overview

Part 1

 

Disability Commission Report

 

The Commission Reports and Commission Concerns

 

General

 

While I found most of the Commissions interests, recommendations, and comments very good, not all fell into that category; at least the way I look at issues using my left-brain logic.

 

I heard too many statements regarding “breaking the bank” from both the Commission as well as the VA Comp and Pen folks that were there.

 

Neither the Commission nor the VA Comp and Pen should consider cost factors in their decision matrices or rationale as to support or not support what they consider as appropriate benefits for dead, dying, or disabled Veterans; or their widows or surviving offspring.  That as they say is outside of their pay grade or it should be.  Of course, we know VA does this constantly and continuously but it should not be a factor in any earned benefit or support nor the consideration of an earned benefit or support.

 

We have millions in fraudulent social program claims being given billions of dollars a year and no one considers what they have done for the nation; nor did they earn it other than having a pulse.  In some states, even a pulse is not required!!!!  Certainly, citizenship is no longer required.

 

So cost factors should be out of the discussion as to recommend or not recommend.  That should be left up to the Congress and our “disingenuous presidents” over the last 60 years.  Thereby by default, left up to the voters to decide, do they support those men and women in the military?  If not, then it would be a decision of each person in the military as to whether they want to continue to support a nation that has in effect turn their backs on them for their own self interest in government social goodies.  In addition to those, that are more interested in supporting the world and not our own citizens, which by the way in spite of the governments best efforts to exclude, includes our Military Men and Women.

 

Therefore, cost factors should be eliminated and banned from any discussions.    

 

Fraudulent claims

 

There seems to be some Commission concern over the increase in claims and the possibility of fraudulent submittals by Veterans; especially in the area of PTSD.

 

Fraudulent is described as:

 

1. Engaging in fraud; deceitful.

2. Characterized by, constituting, or gained by fraud: fraudulent business practices.

 

These definitions actually fit the VA, DoD, and our White Houses more than Veterans.

 

Yes, in any earned benefits and surely, in social services at every level there is fraudulent activity.  We have seen this time and time again and no one seems to be interested in stopping it in the general population, at least at the DC level and even allowing this fraud to continue.

 

The VA is full of employees that have stolen millions, much of it never recuperated.  Stealing money from the widows and orphans funds, getting checks for men who died decades ago, those that are service connected themselves bypassing the rules and processes we have to face and having their fellow employees grant them compensation increases, etc.  I have posted the actual media accounts on this subject as well as the subcommittee findings on this before.

 

Therefore, where does the fraudulent activity reside.

 

More and more, we find that VA is fraudulent in their Herbicide Assessments, Gulf War Assessments, and the biological chemical warfare testing of our Veterans that then they say for national security those men and women are not to be notified of possible findings in their health status and those health findings are not to be made public.

 

In this particular from of deceitfulness (fraud) there is more than money at stake; with direct criminal activity that creates pain and death.  This becomes criminal with criminal intent to harm.  Yet, VA and its employees as well those in the DoD that keep life and death information to themsleves; are protected by FTCA and Feres Doctrine. 

 

Supreme Court Justice Scalia stated:

 

“Feres was wrongly decided and heartily deserves the widespread, almost universal criticism it has received.”  Furthermore, "Congress's inaction regarding this doctrine and its doing little, if anything in the way of modifying it to prevent Constitutional claims is clearly unjust and irrational.  Again, allowing such power to military leaders can and does result in abuse therefore, where are the checks and balances on the military."

 

This is where the Commissions attention needs to be if they are considering fraud in Veterans Issues.

 

Now with that said let me try and defend to some level those that do perpetrate fraud and fraudulent claims in this area.

 

My defense does not include those Veterans that say they were somewhere in combat when other Veterans recognize they are indeed frauds.  I have done so in the past and so has many many Veterans in policing their ranks of this type of fraudulent activity in outing the perpetrator.  Unlike our generic population of those in social programs, we will not stand for anyone claiming what they have not earned by deeds and not just words.  The heavy price paid for our earned benefits is just too high to allow frauds.

 

The commission talked of the increase in PTSD claims.  I will say that for Vietnam Veterans this is not only probably true but also very expected.  No different than the upswing in neurological disorders as we age as compensating alternate neuron activity decays.

 

If you think of PTSD as a load behind a bicycle and the Veteran is peddling as hard as he can to get away from it and the harder he peddles the further away this PTSD load becomes.  Now picture that.  Many Veterans chose different ways of peddling; some alcohol abuse, some drug abuse, some both, and some become work-a-holics.  As they age they can no longer peddle as hard and the load comes closer and closer to the point they can no longer compensate by peddling harder and getting away from the PTSD load.

 

Most of these men will have and have had the same neuropsychological and neuropsychiatric symptoms at varying levels.  Many do not even realize the peddling they have been doing is for a reason but when they are educated and look back on it in retrospect and had they been tested they indeed see the reasons for:

 

·        Experiencing statically significant excess in - psychological disorders of depression, somatization, and severity of psychological distress. 

 

·        Increased significantly higher antisocial and paranoid scores along with psychotic delusion.

 

·        No feelings toward would be friends and their own family members. 

 

The above were the findings from Ranch Hand study that never made the media or their published reports.

 

·        Increased mental disorders

 

 The above is the finding from the study of Army Chemical Corps workers.

 

The Commission discussed DSM-IV and the amount of time it takes to diagnose a Veteran.  Some in the medical community have said they can diagnose in 20 minutes some say it takes at least three hours minimum.

 

I would say it takes at least four sessions with the doctor taking as long as he or she wants including testing.

 

Certainly a one visit is a no brainier as the Veteran could have been having a good day or a bad day.

 

What I did not hear discussed in DSM-IV by the Commission was the probability of an outside source causing the neuropsychological and neuropsychiatric symptoms.  Now as far as alcohol abuse and drug abuse most doctors demand a blood test to “factor out or factor in” those possible outside source of neuropsychological and neuropsychiatric symptoms.  This might even include some endocrine or hormone tests.  If there are physical symptoms such as severe headaches that accompany the diagnosed mental disorders, maybe even a brain scan is ordered.

 

PTSD Differential Diagnoses DSM-IV

 

Differential Diagnosis

 

“The first question that should always be considered in differential diagnosis is whether the presenting symptoms arise from a substance that is exerting “a direct effect on the central nervous system (CNS).” … the next step is to determine whether there is an etiological relationship between it and the psychiatric symptomatology.”

 

Is this being done for our Veterans?  I doubt it.  This should especially be a medical concern for our Vietnam Veterans, Gulf War Veterans, and any Veterans group the DoD has executed biological chemical testing on that group, and also those that served along the *Korean DMZ and other areas where we know that use of toxic chemicals known to demonstrate Central Nervous System effects was prevalent.

 

*The Commission should also look at what DoD and VA has said are inclusive service qualified dates of service on the Korean DMZ for presumptive disorders.

 

This is farce and government perpetrated fraud of ‘the highest magnitude’ of using inclusive dates that do not take into consideration any half-life of the toxic chemical herbicides.

 

EPA Technical Fact sheet on: DIOXIN (2,3,7,8-TCDD)

 

“… The persistence half-life of TCDD on soil surfaces may vary from less than 1 yr to 3 yrs, but half-lives in soil interiors may be as long as 12 years.  Screening studies have shown that TCDD is generally resistant to biodegradation.”

 

“…The volatilization half-life from the water column of an environmental pond has been estimated to be 46 days; however, when the effects of adsorption to sediment are considered, the volatilization model predicts an overall volatilization removal half-life of over 50 years.”

 

Therefore, the inclusive dates used by DoD and VA are not only impractical they are scientifically impossible and do not fit any science model.

 

You should not have a Veteran, given 18 months to live, with two already presumptive exposure cancers along with diagnosed pustular acne before he was discharged that served on the Korean DMZ two months after the fraudulent dates; then deny him associated presumptive disorders because of not considering the half life.  Yet, this goes on daily at the DoD and VA.  This certainly meets the definitions above of both 1 and 2 in what is described as fraudulent.

 

Congress in their consideration of non-military citizens that served on the Korean DMZ considered this half-life into account.  Yet, because of wearing a uniform on the Korean DMZ my Veterans are denied the same benefit given to a civilian. 

 

Darn, where do our sons and daughters sign up to get a uniform for this kind of “special government treatment?”

 

Back to the main point –

 

There was discussion of PTSD cure or is it even curable.  The answer must be it is treatable to a point using medications, awareness of the disorder and situations, recognizable grounding techniques, and constant vigilance of the Veteran in recognizing his deficits and adjusting.  Curable?  No.  However, certainly treatable to a level.  “There is no one-shoe size in PTSD treatment that fits all Veterans.”  (PTSD Core Program VA Doctor David Ready)

 

Therefore, in answer to the Commissions questions on the increase; there is medical and scientific evidence that demonstrates this rise in claims.  Maybe even, more so with the Iraqi Veterans as the scientific community has identified this early on in these Veterans and intervening treatments early on, which should provide a better overall life in quality for these Veterans.  In fact, in some PTSD treatment programs you see Nam, Gulf War, and Iraqi Veterans comprising the same group.

 

What must be considered as the data mounts are the effects of neurological damages or endocrine damages or both that present the same medical effects as PTSD or even may amplify those combat remembrances.  This now comes into play in the Individual Unemployable issues.  Is the mental disorder now considered mental alone or a combination of mental as well as neurotoxin/neurotoxic damages.  On the other hand, just physical issues dealing with central nervous system neurotoxin/neurotoxic damages in the nervous system and/or endocrine hormone damages.

 

Bearing in mind the following:

 

·      “Evidence also reveals that Dow Chemical, a manufacturer of Agent Orange was aware as early as 1964 that TCDD was a byproduct of the manufacturing process.  According to Dow’s then medical director, Dr. Benjamin Holder, extreme exposure to dioxins could result in "general organ toxicity" as well as "psychopathological" and "other systemic" problems.”  (19)

 

While the word “extreme” is subjective and would also be dependant on many different issues associated with Veterans exposures as to type of ingestion(s), health at time of exposure, chronic or acute or both, BMI, liver mass, life style after exposures, etc.

 

From my studies it looks as if the test/measurement/evaluation equipment at the time of this statement was only accurate down to about 1 part per million.  Therefore, we have no idea what “extreme” actually means to the lower levels of exposures regarding this statement.

 

How many doctors could actually tell the difference in what the government is calling PTSD and toxic chemical induced neuropsychological disorders?  How many doctors were even made aware of these toxic chemical findings?  Does this Commission recognize these findings and the Harvard Medical blind studies that demonstrated not only PTSD but also significance of neurological issues found in Vietnam Veterans diagnosed  with PTSD.

 

How many doctors are aware of the other studies where there was no combat in the exposed group that found associated mental disorders and personality changes including suicidal tendencies associated to exposures to the dioxin, TCDD?  Is this Commission aware of these studies and their findings?

 

Now lets put your feet in the Veterans shoes.  He knows, as the whole world knows, that chemical company lobby money has purchased a rewriting of medical history.  Government interference in studies, VACEH that was biased against Veterans, and a whole army of high ranking politicians and budget folks against him including the Secretary of the VA at the behest of Presidents gone bad against Veterans, protocol changes, no scientific intellectual freedom, recently admitted to fatal flaws in the governments so called pivotal study, etc.

 

He goes to the VA indicating he has this or that or a bunch of issues known to be caused by herbicide exposures.  The VSO explains that these are not on the presumptive list and what is more important somehow the Secretary of the VA has not only not found those presumptive but has stated some of those disorders are not ever associated.  This is then used by the BVA to deny claims even in a 50/50 tie.  In other words, the Veteran has about as much chance as a snowball in Hell, except if he fits in with the White House yearly quota in budget control.

 

Then the VSO says do you have a CIB or a CAR or a Purple Heart or a decoration for Valor.  If the Veteran does the VSO then suggests lets put in for PTSD, at least you will get something. 

 

Now as I point out below in Dr. Kang's study of the chemical corps workers the finding that these men are ill and some are unable to work.  The Veteran is in the process of losing his home and his car has already been collected then says OK out of desperation.  Yes, it is fraud but then government fraud, corruption, and collusion has driven him to it.  In an honest government and honest processes none of this would have been necessary.

 

No, two wrongs do not make it right but desperate men for their families do desperate things; including sacrifice their integrity.  Our government has stripped more honor and integrity from those that served with honor and valor than we will ever recognize or know by their own deceitfulness.

 

Some of these factors are an important part in the next topic of Individual Unemployable ratings and considerations.

  

Individual Unemployable (IU) ratings and considerations

 

The Commission seemed to be concerned with this subject of IU.  What I did not know but should have guessed, many VA ratings tables, the way you rate issues, and the rules have not been changed since prior to WW2.

 

Since PTSD was only brought to the medical forefront in our Vietnam Veterans in their returning issues and problems then of course these regulations are now outdated.  However, I once again point out the differential diagnostic issues that must be included in PTSD diagnosis of neurotoxin and neurotoxic involvement.

 

Statistics with verified and repeatable scientific studies do not lie; only our government lies about it.

 

I think it is obvious if the rating processes have not been changed since WW2 this was based on obvious and clear physical disabilities of war wounds.

 

This cannot apply to Veterans from cumulative disorders that one cannot visually picture from neurotoxin/neurotoxic/radiation, etc damages.

 

A rating of IU demanding that one disability be rated at a mandated N factor percentage before IU is awarded cannot and does not apply in the case of "general organ toxicity" as well as "psychopathological" and "other systemic" problems from TCDD exposures.  These maybe considered connective tissue disorder of varying symptoms or even partial subsets of varying immune system disorders but certainly to have one ICD code mandated to be of N-value before IU is awarded couldn’t apply to the many testing abnormalities in many systems that may be found associated with any neurotoxin/neurotoxic/radiation, etc or damages in cumulative total.

 

Veterans have felt the sting of these issues in disability and even deaths from these cumulative effects and have never been compensated for any of them.  Yet, they are unable to work full time or the disorders limit the kind of work they were trained to do thereby deceasing their income directly associated to exposures and their military service.

 

We have known this for quite some time as far back as 1987 in those that were exposed experiencing daily disabling chronic fatigue.  Our DoD or our government did not bring this issue forward.  In fact, the statement in congressional testimony in 2000 by Dr. Richard Albanese was that these men were quite ill with a number of body function disorders.

 

Recently we have Dr. Han K. Kang who is the Director of Environmental Epidemiology Service, Department of Veterans Affairs that makes this case in his study of Army Chemical Corps Workers quite clear in this matter.

 

His study found in Chemical Corps workers in Vietnam and Chemical Corps workers in the states significant increases in Odds Ratios of several disorders, which are still not compensated by VA at the behest of the DoD/White Houses connections. (more on that in discussion of claims in Part 2)

 

I would add here for the Commissioners that the adjusted significant Odds Ratios found were:  Adjusted odds ratios and 95% confidence interval for each disease condition with spraying herbicide in Vietnam was derived from a logistic regression model with adjustments made for age, race, body mass index, rank, and regular smoking.  It seems clear, that any issues that could be confused with the findings were indeed factored out in VA statistical modeling.

 

However, it seems that Odds Ratios intrinsically assumes a linear dose response, which is not scientific at this point in many disorders associated to the dioxin, TCDD.  Therefore, the real numbers are still in question.  It is sufficient to say the numbers in statistics would only get higher, ignoring this unproven liner dose issue.

 

Looking at what Dr. Kang found in his study it is obvious from the findings that these men are ill and may be not diagnosed with the many symptoms that can be attributable to the dioxin, TCDD exposures; much less the other dioxin isomers and closely related dioxin like furan isomers, which are being ignored.  Including, which I must point out, there may not be a diagnostic code for the sick Veterans other than multiple immune system dysregulations or some sort of systemic system connective tissue disorder or both.

 

Diabetes in this study was found at an adjusted Odds Ratio at 95% CI of 1.49.

 

Veterans that their health was poor was found at an adjusted Odds Ratio at 95% CI of 1.57. 

 

This included that out of an N number of 1473; 33% of which their present health limits the kind and amount of work they can perform.

 

The N-number was all exposed victims that served in the Military in Army Chemical Corps that sprayed the herbicides.  Now my assumption is that enough correlation data was compared between the two cohorts of actual similarities of processes, types of chemicals, toxicity of chemicals, etc to make this study a valid study.

 

This study was by our own Veterans Affairs and we still do not have presumptive pronouncements on these issues even though other studies found the same thing decades ago.  More on the other issues this study found, as I cover the 600,000 outstanding claims backlog later.

 

So there are many questions to be answered by VA in this issue as to IU and how what they are doing now corresponds to at least 1980’s body systemic disorders and not just to physical war wounds.

 

This is also, where I made my case as to the gates the VA puts on qualifying for DIC for the widows and offspring for extra dollars.  That also cannot apply to Veterans that are also sick and disabled from toxic chemical war wounds.

 

When does IU end?

 

I think this one can be a minimal impact if folks look at this in honesty of ratings as to disabilities versus ratings.  This seems to be a problem created by VA to minimize the cost and not rationale logic as I have discussed above in actual disabilities versus cumulative effects.

 

Most of the issues of IU would go away given an honest assessment and honest ratings.  Now that might take some give on VA’s part.  For example, if a Veteran has multiple cumulative effects and is at 80-90% disability.  In any cumulative computation of separate issues, there is always an accumulation of errors.  Maybe the award should be 100% with a revisit of the medical issues every two years for ten years.  If the issues have not improved by then, the chances are they are not going to improve, the award should be similar to Social Security, “Not Expected to Recover nor Improve,” and then the award of 80% to 100% is final.  If there were improvement then the fair thing to do would be to reevaluate the effects.  In most cases, what would be found is not improvement but a worsening of the cumulative effects. 

 

At some point in time, IU if it is indeed IU must be reconsidered since the Veteran is no longer able to work because of age.

 

Again, I would suggest if honest assessments were given in the first place and some other avenues of approach were considered as suggested similar to Social Security, this IU would be very minimal at best.

 

These are difficult issues to answer/address and I do not envy the Commissioners work on these subjects.

 

Compensation for Loss of Earnings

 

This is one that I think gets into social economic factors and should be irrelevant.  How in the world would anyone do this?  Base it on rank, MOS, civilian jobs held, the varying IQ’s, education, how many degrees a Veteran has, some formula that plugs in the entire previous subcategories, etc.  Regardless of social economic factors, everyone takes the same risks on the battlefield.  To somehow conclude that ones life or ones disability deserves more or less than the fellow next to you on the same battlefield seem somewhat invalid and nonsensical.  You knew the risks when you went in and now to even consider this loss of earning issues compared to someone else is way to subjective as to "what could have been" or "what might have been."

 

Quality of Life Factor Compensations

 

I think everyone is having problems with this one.  IOM indicated this should be a factor in compensations.  I have yet to come up with any kind of sane analysis on this one that would make sense and I am sure the Commission is struggling with this also.

 

Obviously there are house bound or almost house bound that their quality of life is so degraded they have to have a caregiver sometimes 24 and 7.  Just as obviously, anything to make the Veterans issues more comfortable for not only him or her but to assist the caregiver must be addressed and funded.  I believe we have that now but it seems impossible to get and prove and the funding is less than adequate for today’s economy.

 

One of my WIA Khe Sanh Marines is quadriplegic + and in need of care 24 hours.  He was detailed to spray Agent White out at Khe Sanh as an 0311 grunt with no training at all in the mixing and spraying of toxic chemicals.  He did this no different than filling sandbags, reinforcing bunkers, stringing defensive wires, burning the waste barrels and such; it was just a detail given like any other detail; only with deadly consequences for himself as well as others if not done properly.  His neurological system is destroyed yet VA will still not compensate him at 100%. 

 

At What Rate Should the Compensations be Given?

 

Surely there is some sort of index that cannot be manipulated by the White Houses, congress, and VA to minimize the rate of compensation that would also tie into yearly increases as the cost factors of living go up.

 

As to the question of is the current rates enough?  I think the 100% for a "Veteran with a spouse only" is about $2700.00 a month tax-free.

 

If one considers that is equivalent to a job that pays around $3500.00, a month, which would be about $42,000 a year then Veteran and spouse could live comfortable in a town called In-Between, Georgia.  It would not be the same for New York City or a place in the Hampton’s or similar. 

 

In addition, at 100% other state benefits take over.  Some states have progressive Veterans disability as applied to real estate taxes while some have only 100% rated as to the voiding of any responsibly for real estate taxes.  These benefits become cumulative in putting in additional dollars into the disabled Veterans pocket.  On fixed income, these add up in cash in hand.

 

So how much is enough and where was the current base amount derived?  I have no clue.  I hope not during WW2 with cost of living indexes added all these years.  Christ the middle working class, what is left of them anyway, is still trying to recover from the Carter Administration and the 12 to 16 % inflation rates per year back then.  I do know that some congressional folks have stated that no one can live on the current rate.  (Living in DC that is probably true.)

 

Is the answer to fair compensations regional, or by county or some other measurement tool as to the cost of living?  I have no idea on this one and again I am glad the Commissioners have to address this one.  I am biased in this one because I would never choose those areas of high costs of living but then I am from the South therefore I have no reason to want to live in those other areas even when I could afford it while my career was in full swing.

 

I do know for example:

 

I am on Humana Gold Social Security Plus hospital and doctor insurance.  I pay $43.00 a month for the extra coverage.  If I lived in the Macon, Georgia – Alabama area there is no charge due to cost of living difference.

 

I would think - if the insurance companies do this offset by county or region; then whatever delta is considered, if any, could be handled by the U.S. Government.  (Although with their performance that is strictly an assumption on my part.)

 

Certainly, the issue of “VA math” for compensations needs to be addressed as it also only applies to physical war wounds and not the plethora of chemical wounds and outcomes.  This math seems to at a 500 - 600 level Masters Course to even understand how and what they are doing.

 

Concurrent Receipt - has it gone too far?

 

I am not retired military so here is my take on this.

 

Concurrent Recipient was a band-aide to get votes and that is about it.  While it has helped some retired Veterans.  The answer should have been to do away with this archaic and despicable Veterans Disability Tax that was implemented as a cost savings to the government - not fairness to the disabled Veteran.

 

I hear this it is like the Veteran is double dipping from the same bucket.  That to me is simply a crock.

 

Example:

 

An officer reaches his plateau for permanent rank in the Military at an early age – he knows it and the Military knows it.  You Veterans know how this works.  He puts in his 20 years and fulfills his required service for his "earned retirement."

 

He takes a job with Rockwell Missile as a program manager, or project manager, or even in Operational Analysis.  Hi is young enough to have a second career and earn a much bigger retirement at Rockwell plus his already earned military.

 

He then after working at Rockwell for a few years is struck down by something associated to his wartime service in Vietnam or Gulf War or whatever.  He then is given presumptive associations to “government caused disability” to a level of 40%.  This now takes him out of his high paying job, as he can no longer function as required by Rockwell.  Now at Rockwell the former officer was making anywhere from 50K to 75K as an example with a chance to move up.

 

Assuming his earned retirement is 2K a month, which is probably out of line but just as an example.  His 40% government caused disability is now awarded at $556.00 a month.  A dollar for dollar offset is invoked and his retirement pay already earned is reduce to $1444.00 a month with the only actual disability payment made is the $556 going back to the 2K total that is not taxable.

 

Not much compensation from a government that created the disability and in fact ruined his second career.

 

The government buckets are not the same as far as I am concerned.  One bucket being his earned retirement and the other bucket being his earned disability compensations that were created by our own government and the galatically stupid folks at the DoD, Secretary of Defense at the time, and the President at the time; The dynamic duo of Johnson and McNamara that killed and maimed more Veterans than the NVA and VC combined.

 

More to come on VA Comp and Pen, IOM, backlog of claims......assessment

 

Kelley