April 2000/May 2000
Duggins' Request To VA: Widen Service-Connected Definition
By Philip A. Litteer, Chair, VVA National Government Affairs
Committee and Rick Weidman, Director of Government Relations
Rep. Bernie Sanders (I-Vt.), left, confers with
chairman Rep. Christopher Shays (R-Conn.) at the March 15 oversight
hearing of the House Government Reform Committee.
On April 27, VVA National President George C. Duggins delivered a
formal request to Secretary of Veterans Affairs Togo West, Jr. The request
asked that diseases and medical conditions experienced by Vietnam veterans
at greater-than-to be-expected incidence be declared presumptively service
connected due to the in-country effect of having been stationed in the
Vietnam theater of operations.
As President Duggins noted in his letter: "Put simply, the
in-country effect is the longitudinal impact of a veteran's service in
Vietnam during the Vietnam era upon his or her current state of physical
and psychiatric health. Rather than viewing a Vietnam veteran as suffering
from multiple separate and distinct physical or psychiatric disorders, the
focus should be on the interrelationship among such disorders and between
them and the environment in which the veteran served.''
Duggins went on to note that there can be "no doubt that Vietnam
during the war constituted much more than a hostile environment due to
The guiding principle behind the in-country effect is the concept of
total environmental impact of service in the war upon total physical and
mental health. Such conditions would include adult-onset diabetes
mellitus, hepatitis C, cancers of all sorts, and many other diseases and
These problems could continue to engage individual veterans who are
suffering and VVA and other advocates in the endless debates about
causality. In fact, specific causality mechanisms of disease are not
important as long as we know the incidence among those exposed to the
toxic battlefield in Vietnam is greater than those who did not, and that
it is as likely as not the origins of the condition occurred in military
service in Vietnam.
VVA hopes Secretary West will seize this opportunity to end the
expenditure of efforts on each condition, and that he and President
Clinton display true leadership by helping finally to resolve these
complex issues in a reasonable and humane manner.
Testimony on Legislative Agenda
On March 29, Vietnam Veterans of America National President Duggins,
accompanied by Phil Litteer, chair of the VVA National Government Affairs
Committee, Chief Financial Officer Joe Sternburg, and Rick Weidman of the
national staff, delivered the VVA Legislative Priorities for 2000 to a
joint session of the House and Senate Veterans Affairs Committees.
Duggins stressed that VVA endorsed the Independent Budget of the
Veterans Service Organizations (IBVSO) as being closer to the correct
figure needed to prevent further erosion of the VA services to veterans,
particularly medical services. He went on to say that VVA is as concerned
about how wisely and effectively the appropriated funds are spent as we
are about gross dollar amounts.
Duggins called on Congress to mandate that a thorough assessment of the
total health-care needs of veterans, focusing primarily on the wounds of
war and other conditions resulting from military service to country, be
performed prior to preparation and submittal of the Fiscal Year 2003
budget request. VVA fully endorses the IBVSO budget figures.
However, no one knows how much money is needed to care for veterans in
a manner that will accomplish the mission of returning each veteran to the
highest degree of wellness and independence possible. Duggins noted that
for veterans of working age, the litmus test is assisting veterans to
reach the point where each can obtain and sustain meaningful employment at
a living wage.
This wellness model is in line with VVA's call for the President and
the Secretary of Veterans Affairs to promulgate important regulations to
declare the in-country effect that takes the form of many different
illnesses and manifestations stemming from service on a battlefield.
Among the specific issues Duggins addressed were: POW/MIA, Agent
Orange, hepatitis C, health care, Post-traumatic Stress Disorder and
substance-abuse treatment, and the need for significant reform to make the
veterans employment system work better for veterans, particularly disabled
veterans. Duggins commended Rep. Jack Quinn (R-N.Y.) for his efforts to
reform the declining system of employment offices, and Rep. Vic Snyder
(D-Ark.) and Sen. Olympia Snowe (R-Maine) for their good work on hepatitis C legislation.
For the full text of Duggins' remarks and to see the summary of the
2000 priorities go to VVA Legislative
Congressional Hearing On Hepatitis C
On April 13, the Subcommittee on Benefits of the House Committee on
Veterans Affairs, chaired by Rep. Quinn, held hearings on HR 1020, a bill
that would grant service-connected presumptive status to veterans who now
test positive for hepatitis C and meet conditions that indicate that the
disease resulted from military service.
Such conditions would include the veteran having had an operation or
blood or plasma transfusion prior to 1989, having served as a nurse,
medic, or other medical specialty, or having been exposed to blood in the
course of military duties.
Rep. Vic Snyder, who served as a Marine in Vietnam and who is now a
physician, is the architect and prime sponsor of HR 1020. Testimony was
heard from individual veterans, from the VA, and from a wide range of VSOs
and other veterans advocates.
There is a growing consensus that hepatitis C should be declared a
service-connected presumptive disease and that proper and full health care
will be improved when this occurs. VVA strongly supports HR 1020 and
admires Rep. Snyder for his leadership on this and other vital veterans
VVA encourages all members to contact their representatives and
Senators to educate them about the need for presumptive service connection
for hepatitis C and to ask them to co-sponsor HR 1020 in the House and
S.71 in the Senate.
Other Hepatitis C Efforts
Ken Moore of VVA Chapter 20 in Rochester, NY, is leading the VVA
National Task Force for Veterans Health Care on the issue of hepatitis C.
He joined Terry Baker of Delaware and Heather Renee French, Miss America
2000, April 29 for an outreach to veterans for hepatitis C testing at the
National Vietnam Veterans Art Museum in Chicago.
The Chicago outreach is one of a series funded by Shering-Plough, the
Memphis-based pharmaceutical company that manufactures the medications
that are currently the primary treatment for hepatitis C.
In other action on hepatitis C, VVA President Duggins, in a May 5
letter, called on the Secretary of Veterans Affairs to move quickly on the
formal request that VA publish important regulations that would declare
hepatitis C a presumptively service-connected condition for veterans who
meet basic criteria similar to those found in HR 1020.
Noting that VVA filed that formal request with the Secretary on March
23, 1999, Duggins noted thirteen months had passed, longer than the
average tour of duty in Vietnam. He urged Secretary West to meet his
responsibilities and act favorably on this petition "as a good faith
effort'' while considering VVA's request on in-country effect. Instead of
waiting for Congress to make him deal with the vital needs of veterans
with hepatitis C, Duggins urged him to move now to help these veterans and
their families because the claims system is not doing a good job ofadjudicating claims.
VVA has worked closely with other VSOs on the issue of additional
resources for VA for Fiscal Year 2001. As we noted in the last issue, the
President's budget submittal for the Veterans Health Administration is at
least $500 million short of what is needed to keep the system operating at
the current level. VVA has fully endorsed the Independent Budget of the
Veterans Service Organizations.
The beginnings of this crisis were set in motion several years ago when
the President and Congress agreed to flat-line the veterans health care
portion of the veterans' budget as part of the Balanced Budget Agreement.
The budget passed by Congress in April does not allow enough for the
portion of the budget that includes VA. This is not only the estimation of
VVA, but also is the opinion of Rep. John Edward Porter (R-Ill.), who
chairs the Subcommittee on VA, HUD, and Related Agencies of the House
Committee on Appropriations, Rep. Lane Evans (D-Ill.), and
other key members of Congress. VVA is grateful to Sen. Tim Johnson
(D-Ill.) for his leadership in offering an amendment to the budget that
would have increased the appropriations for VA by $500 million for FY
2001, even though that effort did not succeed.
VVA has the same question now as we did one year ago: If our nation
cannot take proper care of veterans during good times, what is going to
happen when the inevitable recession occurs? It is vital that each VVA
state council, chapter, and member let their senators and representatives
know how strongly they feel about the issue of proper funding for VA,
especially for health care.
To become an active part of the VVA Legislative Network, contact your
state council president and send an e-mail to Sharon Hodge of the VVA
national staff at firstname.lastname@example.org with
your name, address, telephone, and fax numbers, and your position in your
chapter or state council.
VVA commends Rep. Jack Quinn, chairman of the Subcommittee on Benefits
of the House Committee on Veterans Affairs, for his efforts to achieve
meaningful reforms and greater performance accountability in the veterans
employment and training system.
Rep. Quinn and his staff, along with Rep. Bob Filner (D-Ca.), the
ranking Democrat on the subcommittee, have been working hard on achieving
meaningful changes that will insure that good performance is rewarded, and
poor performance is held accountable.
The system which we depend upon to deliver vitally needed assistance to
disabled veterans, recently separated veterans, and other veterans who
need work in getting and keeping decent jobs is in need of modernization.
The enactment of the Workforce Investment Act (WIA) of 1998 two years
ago began the final act in a 20-year decline of the federal/state system
of job-placement assistance known as the State Employment Security
Agencies, or more commonly as the unemployment office.
Essentially, the WIA removed even the requirement that veterans be
given priority service in receipt of employment and training services in
the One Stop Centers that are replacing the Job Service offices.
As the pace quickens to convert all job service offices to One Stop
Centers, VVA believes it is vitally important to strengthen the powers of
the state directors of Veterans Employment and Training to insure that
veterans--particularly disabled veterans and veterans with significant
barriers to obtaining and sustaining employment-- are given the most
effective employment services possible.
States such as California and South Carolina continue to a very good
job overall. However, the lack of consistent standards, financial
incentives for excellent performance, and effective sanctions that include
a last resort of competition make this an uneven system for veterans most
in need. America's veterans deserve better.
Employment placement assistance is vital for programs such as the Vet
Centers, VA Vocational Rehabilitation, and other veterans programs. All of
the good work of these programs will not pay off for individual veteran if
they are not employed.
We simply must approach assisting veterans--particularly disabled
veterans and veterans with significant problems-- in a more holistic way.
In order to insure that these veterans most in need set the proper help to
becoming as well, self sufficient, and autonomous as possible, there must
be consistent and effective job placement and supportive services before
and after job placement.
VVA strongly backs HR 364, the Veterans' Employment and Training Bill
of Rights introduced by the Rep. Filner. This proposed legislation would
give veterans priority of service in every employment, training, and
related services program funded with federal funds.
Small Business Development
VVA is working with Rep. Jim Talent (R-Mo.), chairman of the House
Committee on Small Business, Rep. Stump, and others who co-sponsored the
Veterans Business Development and Entrepreneurship Act of 1999, known as
Public Law 106-50.
This law, when fully implemented, will make significant gains for
veterans and service-disabled veterans in being able to obtain capital and
other needed assistance from the Small Business Administration (SBA) and
other federal entities.
Letters and phone calls should be sent to members of the House and
Senate Committees on Appropriations to press for their support of the $4
million needed to fund the National Veterans Business Development
Corporation created by PL 106-50.
Now that we have succeeded in strengthening the laws giving disabled
veterans and other veterans more business rights, close oversight by
Congress, the General Accounting Office, and the VSOs will be needed to
insure that the new legislation is effectively implemented by SBA.
VVA is concerned that Vice President Gore President Clinton have not
taken steps to insure that this law is fully implemented and its
activities fully funded. As one VVA disabled business owner said,
"What's not to like about helping disabled veterans succeed in
earning their own piece of the American dream--especially when they will
in all likelihood hire other disabled veterans?''
VVA will continue to work with other VSOs and the Congress to secure
proper funding and the fullest possible implementation of the promise of
In further developments on Agent Orange, the Air Force released another
report based on the twenty-year-long Ranch Hand study of those Air Force
personnel who were engaged in the aerial spraying of the defoliants in
Vietnam. The study documented much higher prevalence of diabetes mellitus
(adult onset diabetes) than one would normally expect among these
veterans. The study also indicated that the level of myocardial (heart)
problems, cancers of all types, and other medical problems also were
elevated above the norms one should expect.
In response to the urging of VVA and the demands of Rep. Christopher
Shays (R-Conn.) And Rep. Bernie Sanders (I-Vt.), the Air Force also made
part of the overall data set from which their study was drawn available to
VVA, to Yale University, and to others who may request same. Joel Michalek,
who heads up the Air Force study, has assured Congress and VVA that the
remaining data sets, which contain medical information on the
participating veterans from the beginning of the study through 1997, will
be made available by the end of the year.
Meanwhile, the Secretary of Veterans Affairs directed the Veterans
Health Administration to ask the National Academy of Sciences to include
the latest Ranch Hand report in a special review on diabetes, and to
withdraw from release the latest NAS review that was due to be released in
early May. The NAS has scheduled a scientific forum on the diabetes review
for June 9. It will be open to the public. The hope is that the special
review can be completed and publicly released by October.
On a separate track, George Claxton, chairman of the VVA Agent Orange/
Dioxin Committee, and Linda Schwartz, chair of the VVA National Task Force
on Veterans Health, testified at tjhe National Academy of Sciences,
Institute of Medicine on May 23. The review is due to be released in late