Statement of

VIETNAM VETERANS OF AMERICA

Submitted by William T. Frasure

Deputy Director

Government Relations Department

Before the

House Veterans Affairs Subcommittee on Benefits

Regarding

Gulf War Undiagnosed Illness Claims

October 26, 1999

Mr. Chairman and members of the subcommittee, on behalf of our members, Persian Gulf War veterans, and all American veterans, Vietnam Veterans of America (VVA) thanks you for this opportunity to comment on issues regarding Persian Gulf War veterans. Among a host of Gulf War veteran issues, VVA is seriously concerned about the manner in which Gulf War veterans’ claims are being adjudicated by the Department VeteransAffairs (VA)

First, I would like to applaud this subcommittee and Congress for extending the portion of Public Law 103-466 that pertains to undiagnosed illness claims. As there are still over 29,000 pending claims, and over 132,000 disabled Gulf War veterans, your work remains integral to the claims adjudication process for Gulf War veterans.

VVA firmly believes that the VA interprets PL 103-466 in a limited and overly meticulous scope that has resulted in far too many sick Gulf War veterans having their war-related conditions unattended to. There are different contributing factors to the thousands of mistaken denials of Gulf War veterans’ claims, and each one needs to be addressed.

Many Gulf War veterans have conditions that are not “clearly defined” illnesses (according to the VA). These conditions range from chronic fatigue to fibromyalgia, to multiple chemical sensitivity and a myriad of respiratory, digestive, and muscular-skeletal problems. All of the claims for these conditions are prima facie denied on the grounds that the illness is not “clearly defined.”

Too many times the veteran has produced documents recording a medical condition, only to have his condition labeled as “undiagnosed” by the VA. The claim is then usually denied.

Time and time again, Gulf War veterans are diagnosed with a psychological malady when they seek help from the VA for a physical problem. Surely, many Gulf War veterans are indeed afflicted with psychological problems stemming from war-related incidents and exposure to various toxins and experimental drugs that have possible long term cognitive effects. However, many of the psychological diagnoses of Gulf War veterans by the VA have been hastily applied because the veterans’ conditions are foreign to VA physicians and difficult to precisely diagnose. The logic here is that “if we don’t know what the veteran’s physical condition is, it must be a figment of his mind.”

The average Gulf War veteran is not deeply versed in all the nuances and technicalities of the VA claims adjudication process. While VVA maintains that the VA has a responsibility to ensure that a veteran has professional assistance in developing a claim, unfortunately, many a veteran simply fills out the paperwork on his/her own, and fills it out incorrectly, ignorant of the concept of “developing” a claim.

The bottom line of these noted deficiencies is that 78% of Gulf War veterans’ claims for undiagnosed illnesses are denied. The bottom line is that thousands of Gulf War veterans with serious physical illnesses and conditions have been left unattended to.

VVA ardently supports the suggestion of Chairman Bob Stump, contained in his letter to VA Secretary Togo West (June 3, 1998) that the VA must adopt uniform standards to adjudicate Gulf War claims. Furthermore, as Chairman Stump suggested, we believe it must be clearly noted that the VA must decide in favor of the veteran, when there is reasonable doubt. VVA would like to point out that since no D.O.D. records were kept on the administration of PB pills, Depleted Uranium exposures, chemical agent exposures, and exposures to oil well fires, there should be a clear, stated policy within the VA, that when a Gulf War veteran is attempting to develop a claim that is related to any of these exposures, reasonable doubt should always be established, and the decision made in favor of the veteran.

VVA suggests three immediate steps be taken to remedy the problems associated with the adjudication process of Gulf War claims:

1) There must be further training of VA adjudicators and VA physicians for Gulf War specific cases, particularly in light of the recent decision in Morton v. West, 12 Vet. App. 477 (1999). The U.S. Court of Appeals for Veterans Claims has decided that a veteran’s claim must be well grounded in order for the VA to assume responsibility in assisting the veteran in developing the veteran’s claim. This decision, however, should not be applied to claims involving allegations of undiagnosed illness in gulf War veterans because P.L. 103-446 expressly mandates that such claims are, per se, well-grounded. Consequently, the statutory grant of well-groundedness with respect to Gulf War undiagnosed illness claims removes them from the purview of Morton v. West.

2) Current VA training materials harp too much on stress while neglecting research on toxic exposures and not offering clear guidelines on claim verification reporting procedures for undiagnosed conditions. The VA needs to develop a comprehensive claims processing training program that includes the Veteran Service Organizations (VSO Service Officers) and Gulf War veterans.

3) VVA joins with the National Gulf War Resource Center (NGWC) in urging Congress to see to it that the General Accounting Office (GAO) investigate the discrepancy between the Congressional intent of PL 103-466 and the rather hollow implementation of PL 103-466 by the VA.

The problems regarding claims adjudication of Gulf War undiagnosed illness claims are symptomatic of the overall situation at the VA. VVA sees a lack of accountability, quality assurance, and uniformity in the VA claims adjudication process. While VA contends that the claims adjudication process is non-adversarial, VVA and veterans know otherwise.

VVA suggests the following: 1) Claims adjudicators should receive regular training and should be tested annually for proficiency and job knowledge. Those adjudicators that do well should be rewarded while those adjudicators who “fail to make the grade” should face punitive action; 2)Veterans should have the right to have an attorney assist in the development and representation of a claim at the regional level. and 3) VA, in conjunction with the VSOs, should develop and implement a training program specific to “non-traditional” claims-i.e., claims that deal with conditions that are not easily diagnosed and rely heavily on medical research opinions such as Agent Orange and undiagnosed illnesses. The VA needs to exercise foresight and begin preparing now for the disabilities that are going to be a result of 21^st century combat. Medical science regarding warfare is entering a nebulous, uncharted territory marked by rapid advancements in technology, genetics, and chemical and biological warfare.

There is several other Gulf War veteran issues that we believe need to be addressed. 38 CFR Section 3.317 needs to be amended to allow claims by those American veterans who served in Turkey and Israel since August 2, 1990. Many of these veterans were subject to toxic exposures and now have undiagnosed illnesses. Presently, DoD classifies Turkey and Israel as nations within the Gulf War theater. The VA does not. VVA queries as to what authority VA actually has to define a theater of war. As a result of VA’s definition, many Gulf War veterans have been denied benefits and healthcare.

Approximately twenty U.S. veterans were taken prisoner by Iraq and held between August 1990 and December 1990. Currently, these veterans are not classified as Prisoners of War and thus are not eligible for certain VA benefits that they certainly are entitled to. DoD classifies these veterans as “beleaguered.” VVA finds this to be a disgrace and urges Congress to reclassify these veterans as “former prisoners of war.”

In light of recent Pentagon admissions of multiple and widespread toxic exposures, VVA believes that the provision of PL 103-466 calling for medical evaluations of spouses and children of Gulf War veterans needs to be extended. The VA has hesitantly implemented this program that is set to expire on December 31, 1999.

VVA roundly applauds Congress for the enactment of PL 105-277. As a result of PL-105-277 the National Academy of Sciences (NAS) is reviewing reports on 30 toxins (in the Gulf War theater) and their associations with illnesses. Until NAS completely finishes their work, benefits for undiagnosed illnesses, available under 103-446, should have an open presumptive period.

We support Congress’s request for a GAO inquiry into depleted uranium exposures and Gulf War undiagnosed illnesses. DoD failed to follow prescribed safety regulations regarding DU in the Gulf War, despite thousands of soldiers being exposed to DU. Upon the release of the GAO report, Congress should hold hearings on this matter.

VVA observes with exasperation the recent prompt apologies to Department of Energy (DoE) workers for DU exposures. DoE swiftly implemented safety training, healthcare, and compensation for those affected workers. We are miffed at the disparity of treatment between exposed U.S. federal civil service workers and exposed U.S. soldiers. We urge congress to request the Departments of Defense and VA to comment on this disparity.

The recent announcement by the RAND corporation that PB pills “cannot be ruled out” as a causal factor of Gulf War undiagnosed illnesses has served to only solidify the established pattern of dishonesty, arrogance, and deception by DoD in regards to Gulf War undiagnosed illnesses. DoD publicly made the blanket statement that no soldiers were exposed to low level chemical agents. It is now a known fact, a fact that was covered up and unearthed, that thousands of soldiers in the Gulf were exposed to low level chemical exposures. DoD made the arbitrary statement that PB Pills pose no health risk and are not a cause of Gulf War undiagnosed illnesses. It has now been found that PB pills just may in fact be a causal factor of Gulf War undiagnosed illnesses.

The absolute bottom line is that thousands of Gulf War veterans remain sick and are not receiving healthcare by the VA. These facts are well known outside of Washington D.C. and have served as a major factor in the current recruiting dilemma of the military. While DoD has expended vast resources toward downplaying the problem of Gulf War undiagnosed illnesses, high school students across the nation have received the word from their brothers, sisters, friends, and cousins that the military is a raw deal. It is the common perception today among youth that it is simply not worth it to join the military. This perception is in large part, a direct result of DoD’s handling of the Gulf War undiagnosed illnesses issue.

VVA urges Congress to keep in mind the bottom line-the health of our veterans, and to ensure that DoD does not repeat this debacle.

Again, thank you for this opportunity to comment on Gulf War undiagnosed illnesses. I stand ready for any questions you may have.

VIETNAM VETERANS OF AMERICA

Funding Statement

October 26, 1999

The national organization Vietnam Veterans of America (VVA) is a non-profit veterans membership organization registered as a 501(c)(19) with the Internal Revenue Service. VVA is also appropriately registered with the Secretary of the Senate and the Clerk of the House of Representatives in compliance with the Lobbying Disclosure Act of 1995.

VVA is not currently in receipt of any federal grant or contract, other than the routine allocation of office space and associated resources in VA Regional Offices for outreach and direct services through its Veterans Benefits Program (Service Representatives). This is also true of the previous two fiscal years.

For Further Information, Contact:

Director of Government Relations

Vietnam Veterans of America.

(202) 628-2700, extension 127

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