Secretary Shulkin Responds to Congressman's Inquiry Regarding Burn Pits

Secretary Shulkin Responds to Congressman's Inquiry Regarding Burn Pits In early September 2017, Representative Mike Coffman of Colorado sent a letter directly to VA Secretary David Shulkin. The letter–an official “Congressional inquiry”-urged Shulkin to address the lack of necessary diagnostic capabilities at VA Medical Centers and the total absence of disability rating guidelines for deployment-related lung diseases (DRLDs) like constrictive bronchiolitis. In late October, Secretary Shulkin responded.   Coffman's Letter In July, Burn Pits 360 partnered with Amnesty International to present a Congressional briefing on the challenges faced by veterans exposed to burn pits. After listening to the experiences of veterans and experts at the briefing, Rep. Coffman was inspired to take a stand.  To make the letter as compelling as possible, Rep. Coffman worked with two of the expert panelists, Dr. Richard Meehan and Kerry Baker. Dr. Meehan researched burn pits as a Marines medic in Iraq and now co-directs the Deployment-Related Lung Disease Center at National Jewish Hospital. Kerry Baker is a leader in the fields of toxic exposure and veterans’ benefits and represents disabled veterans at the law firm of Chisholm Chisholm and Kilpatrick. In the Congressional inquiry letter, Rep. Coffman urged the VA to: Revise their disability criteria to address the respiratory issues faced by veterans with DRLD  Give veterans access to academic and other non-VA referral centers with expertise in specialized pulmonary testing Meet with leading members of the medical community to discuss how VA can better address DRLD in veterans Shulkin's Response When a Congressional inquiry arrives at the VA, the letter is first sent to subject matter experts within the appropriate branch of the VA and then sent back up the chain of command for approval. Secretary Shulkin then gives final authorization to send the inquiry response back to the lawmaker who submitted it. In this particular Congressional inquiry response letter, VA officials (with Shulkin’s endorsement) answered Rep. Coffman’s concerns with an overview of things the VA is allegedly already doing to help veterans with DRLD.  But officials failed to explain meaningful restrictions and conflicts of interest that severely limit the potential effectiveness of the programs and research initiatives discussed.   DRLD Rating Criteria   “Analagous” ratings are not enough In the response letter, Shulkin acknowledged that there is no diagnostic code or rating criteria for deployment related lung disease (DRLD). Instead, he says, DRLD is rated as “analogous” to an “appropriate respiratory condition.” Unfortunately, the conditions deemed “analogous” – typically asthma or chronic obstructive pulmonary disorder (COPD) – are rated based on pulmonary function testing that does not detect or show the full severity of DRLD. When discussing the lack of rating criteria for DLRD, Shulkin acknowledged that the “VA recognizes the challenges with rating this condition to include situations where objective testing may not adequately demonstrate the severity of symptoms.” And, in fact, the VA sent out a Training Letter seven years ago that stated the same: many VBA adjudicators are having serious trouble rating these conditions. Relying on “analogous” conditions may be appropriate for some service-connected disabilities, but for a condition as severe and difficult to measure as DRLD, this solution is unacceptable. Asthmas and COPD are simply not analogous to DRLD. Nearly 125,000 veterans have filled out the Burn Pit Registry questionnaire and, nearly 17 years after the beginning of the wars in Afghanistan and Iraq, reports of DRLD in post-9/11 veterans are only increasing. There is clear need for these rating criteria and their absence leaves sick veterans at a loss.   Public comment can only do so much Though he mostly reiterated that there is no rating criteria specific to DRLD, Shulkin also proposed a flimsy “solution” to the problem. According to Shulkin, the Veterans Benefits Administration (VBA) is currently in the process of revising the Veterans Affairs Schedule for Rating Disabilities (VASRD), which includes the rating criteria for respiratory conditions. Part of this process entails opening up the “proposed rule” – the VA’s revised rating system for respiratory conditions - for public comment in the Federal Register. In the letter, Shulkin suggests we take advantage of the public comment period, which VA plans to publish in April 2018. Even if the VA manages to publish the proposed rule on time and to revise it in a meaningful way, the rule… must go through another lengthy internal review process where it could be revised again, may not become law for months or even longer, and will NOT apply to veterans who are already rated for DRLD. In other words, the revision process will take a very long time, some of the sickest veterans will see no change in rating, and meaningful revisions are not at all guaranteed. Those who have suffered from deployment-related lung disease for years (and managed to get service connection from the VA) would continue to get benefits that do not accurately reflect their suffering.   DRLD Research and Collaboration In response to Rep. Coffman’s call for the use of academic referral centers and collaboration with the greater medical community, Shulkin discussed several research and collaboration initiatives the VA already has in place. He did not mention, however, that the results of most of these initiatives are often inaccessible to affected veterans and even doctors. Additionally, many of the initiatives are run by the VA and/or the Department of Defense (DoD), both of which have financial and legal incentives to prevent meaningful research and collaboration. As an example of collaboration with leading members of the medical community, Shulkin cited the periodic series of “Airborne Hazards Symposia” hosted by the VA and DoD. He mentions that participants in the last symposium included a representative from National Jewish Health (the hospital where Dr. Meehan works). What he fails to say, however, is that that representative was hand-selected by the VA. The symposia are, in fact, invitation-only and entirely closed to the general public and the press.  Shulkin also noted that VA subject matter experts (SMEs) and researchers “actively collaborate with colleagues at the Department of Defense (DoD).” Though both federal agencies should actively engage with the issue of burn pit exposure, there are clear reasons the public and other medical professionals should be skeptical of the findings they produce. Both VA and DoD have significant incentives to avoid financial and legal responsibility for the already-sick veterans exposed to burn pits – and even more incentive to avoid responsibility for the over one million veterans potentially exposed that may become ill later. The agencies to blame for initially exposing veterans and for failing to effectively treat and compensate them once sick, should not be the only medical researchers working to reveal the true impact of burn pits and compensating veterans for that impact. Such an arrangement is a conspicuous conflict of interest. This article was written by Chisholm Chisholm & Kilpatrick.  CCK is on the cutting edge of burn pit and other toxic chemical exposure issues that veterans face.  CCK has extensive experience helping veterans win their VA disability compensation claim appeals.  Contact CCK for help if your VA disability compensation claim has been denied.  Visit CCK onlineor by phone at 844-291-8569 for more information.

"Biden addresses possible link between son’s fatal brain cancer and toxic military burn pits" On January 10, PBS News published an article addressing the possible link between Joe Biden’s son’s fatal brain cancer and his exposure to burn pits at Camp Victory in Afghanistan and Balad Air Force Base in Iraq. Reporter Dan Sagalyn, in addition to speaking with doctors and experts looking into the medical impact of burn pit smoke, interviewed and featured Burn Pits 360 founder Rosie Torres. Read the eye-opening article here. Legal Help for Veterans Disability Benefits:  If VA has denied your disability compensation claim, assigned you the wrong impairment rating, or if you are entitled to an earlier effective date, contact Chisholm Chisholm & Kilpatrick for assistance.  CCK is also experienced at helping eligible veterans get VA benefits for special monthly compensation (SMC) or total disability rating based on individual unemployability (TDIU).  Contact CCK toll free at 844-291-8569 or visit CCK online.   Take Action to Prove the Connection Between Burn Pit Exposure and Illness by Participating in the Burn Pits 360 Registry Research Study The Burn Pits 360 Registry is a research study, collecting data on burn pit exposures and related illnesses.  The goal is to prove the connection between burn pit exposure and illness.  Before now, this information was only available to the Departments of Defense and Veterans Affairs.  So far, over 5,000 individuals have participated.  Your data will enable Burn Pits 360 to advocate and lobby on behalf of the veteran community for VA benefits, policy change, and specialized health care. To participate, visit us on our website here. PARTICIPATE NOW Donate to Burn Pits 360 Burn Pits 360 Needs You!  The success of our mission depends on the generosity of individuals like you.  We ask you to consider a monthly donation to help us advocate for our community and its needs. DONATE TODAY! Connect with us Burn Pits 360 on Facebook Burn Pits 360 is community of veterans with burn pit-related illness, their families, and advocates with the common goal of exposing the harms of toxic burn pit exposure and obtaining benefits and policy change. Join us. Like us on Facebook! Meet the Burn Pits 360 Team Founder: CPT (Ret.) Le Roy Torres Executive Director: Rosie Torres Secretary: Tammy McCracken Program Manager: Will Wisner Legislative Liaison: Cindy Aman Director of Development:Daniella Molina Advocates Rocio Alvarado (California) Diane Slape (Texas) Advisory Board Ret. Colonel David Sutherland Dr. Steven Coughlin Ret. Lt. Col Gregg Deeb Dr. Robert Miller Ret. Lt. Col. Brian Lawler Kerry Baker

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