Compensated diseases disputed

By Tom Philpott: Military Update

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.

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.

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.