A publication of Vietnam Veterans of America, Inc. ®
An organization chartered by the U.S. Congress

April 2000/May 2000

Government Relations

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 enemy action.''

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 medical conditions.

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 Priorities 2000.

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 issues.

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.

Legislative Network

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 shodge@vva.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 PL 106-50.

Agent Orange

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 December.


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