VA Sec. Shinseki on Gulf War illness, Agent Orange: "We Will Get This Right"

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com - Friday, August 28, 2009) -- In a series of major policy announcements during the annual August round of veterans' service organization national conventions, newly appointed VA Secretary Eric Shinseki publicly recognized the plight of veterans afflicted by Gulf War illness and Agent Orange, and pledged that the VA under his leadership will, "get this right."

In key speeches before the Association of the United States Army (AUSA), American Veterans (AMVETS), Veterans of Foreign Wars (VFW), Disabled American Veterans (DAV), Blinded Veterans Association (BVA), and the American Legion (LEGION), Shinseki has repeatedly noted the serious problems affecting these veterans, decades after their military service, stating, "We must do better, and we will."

Shinseki was candid in his assessment of the challenges the new Administration faces in leading the VA, attributing problems to "someone cutting corners;" "failures in leadership, behavior and professional ethics;" and "systemic" issues.

"These issues will only be resolved when a sense of responsibility, accountability, and discipline is established throughout VA—from my office to the farthest reaches of our footprint," said Shinseki. "We are your advocates, and we have begun to retrain the workforce."

Gulf War illness issues -- which have long lingered unaddressed -- have been carefully noted by the new Administration, including through meetings with key Gulf War illness advocates and members of the White House Transition Team shortly after the election, correspondence by key veterans advocates and organizations, an ongoing series of Congressional oversight hearings into the impact of VA's previously limited scope of Gulf War illness research not focused on treatments or improving lives this summer, and a July high-level meeting between an array of top VA officials and several members of the Research Advisory Committee (RAC) on Gulf War Veterans' Illnesses.

The full relevant text from Secretary Shinseki's speech before the American Legion is as follows:

Five years from now, we intend to be the provider of choice for more of that larger population of 23.4 million Veterans—in insurance, in healthcare, in education, in home loans, in counseling, and in employment.

To achieve this kind of status with Veterans, we must make it easier for them to understand their entitlements and then make it much simpler for them to access their benefits and health care services.

Beyond the five years, we’re looking for new ways of thinking and acting. We are asking why, 40 years after Agent Orange was last used in Vietnam, this Secretary is still adjudicating claims for service-connected disabilities related to it. And why 20 years after Desert Storm, we are still debating the debilitating effects of whatever causes Gulf War illness. Left to our present processes, 20 or 40 years from now, some future secretary could be adjudicating service-connected disabilities from our ongoing conflicts. We must do better, and we will.

If you haven’t already heard, the Institute of Medicine recently released a new study on a possible link between Agent Orange and heart disease and Parkinson’s. We have this study under review now, and I assure you—we will get this right.

Any organization our size is bound to have occasional disappointments, and we have not been spared them in recent months. Many of these issues occurred in the past, but I take full responsibility for fixing them. Some of these disappointments resulted from someone cutting corners, while others were failures in leadership, behavior and professional ethics. And still others were systemic.

These issues will only be resolved when a sense of responsibility, accountability, and discipline is established throughout VA—from my office to the farthest reaches of our footprint. We are your advocates, and we have begun to retrain the workforce.

My remarks this morning comprise a seven-month progress report on the state of your Department of Veterans Affairs. I intend to do this again next year. Much more remains to be done. We need your continued support and assistance if we are to become the provider of choice.

My mission is to serve Veterans by increasing their access to our benefits and services, to provide them the highest quality of health care available, and to control costs to the best of my abilities. Doing so will make VA a model of good governance. Doing so will also keep faith with President Lincoln’s charge to care for those who have borne the battle and grant them the dignity and respect they deserve until they are laid to rest. That is my mission.

We look for your advice and support in all of these endeavors.

Change is coming...

CNN: VA to Apologize for Mistaken ALS Disease Notifications

Written by Ashley Hayes, CNN

(CNN) -- The Department of Veterans Affairs said Wednesday it will apologize to veterans who were mistakenly told they'd been diagnosed with a fatal neurological condition.

Letters were sent last week to 1,864 veterans and survivors, the VA said in a written statement. They were supposed to be sent to veterans with ALS -- also known as Lou Gehrig's disease -- to keep them apprised of expanding benefits eligibility.

"According to the records of the Department of Veterans Affairs (VA), you have a diagnosis of amyotrophic lateral sclerosis (ALS)," said the letter, according to the National Gulf War Resource Center. "This letter tells you about VA disability compensation benefits that may be available to you."

But some who received the letters, like Brent Casey, do not have ALS. Casey, a disabled Army veteran from the first Gulf War, told CNN that when he received the letter, he was "just completely beside myself. Just floored. Went into a complete and total meltdown. I couldn't speak, couldn't -- I guess I was, truthfully, speechless."

After hearing from veterans who received the letter but do not have ALS, the VA immediately began reviewing individual claims files for all the recipients to determine who received the letter by mistake, agency spokeswoman Katie Roberts said in the statement. "VA employees are personally contacting these individuals to ensure they understand the letter should not be confused with a medical diagnosis of ALS, explain why they mistakenly received the letter and express VA's sincere apologies for the distress caused by this unfortunate and regrettable error."

"It's not right for it to happen this way," Casey said. "Regardless if it was the case that I was diagnosed with ALS, that would be the worst possible way for an organization to let an individual know."

Upon receiving the letter, some veterans sought a second opinion outside the VA, according to veterans' service organizations, paying for doctors' consultations out of their own pockets. The VA said it will reimburse those veterans for the costs.

In addition, the VA said it is reviewing its notification process to make sure a similar error doesn't happen again.

The AmVets service organization is "encouraged" by the VA's response to the situation, and pleased to see they caught the error, said spokesman Ryan Gallucci.

================================
According to the VA:

STATEMENT:

Last September the Secretary of Veterans Affairs made amyotrophic lateral sclerosis (ALS) a presumptively compensable illness for all Veterans with 90 days or more of continuous active service in the military. As a result, the Department of Veterans Affairs (VA) can now pay disability compensation to Veterans with ALS. Their survivors are also eligible for VA benefits.

In an effort to provide Veterans this new and much-needed support, VA sent notification letters to Veterans with ALS advising them of their potential eligibility for disability compensation benefits. On August 13, 2009, VA sent outreach letters to 1,864 Veterans and survivors across the country. Unfortunately, VA made a coding error and a number of Veterans who should not have received this letter did. The Department is reviewing individual claims files for all the recipients of this letter to identify those who received it by mistake.

VA employees are calling Veterans and survivors to ensure that they understand the purpose of the letter, explain why they mistakenly received the letter, and express VA’s sincere apologies for the distress caused by this unfortunate and regrettable error.

Q & A:
 

Q: How many Veterans have been affected?

A: Approximately one third of the letters VA sent were miscoded.

Q: Will VA be issuing a formal apology?
A: Yes, the Department is calling all affected Veterans and will also be issuing them a formal letter of apology.

Q: Why did Veterans who do not have ALS get letters?

A: VA used data and information from its data base to identify Veterans diagnosed with ALS or who had filed a claim for ALS, but were not currently receiving disability compensation benefits for the condition. However, as a result of problems in the codes VA used to identify these Veterans, VA sent the letter to some Veterans who do not have ALS.

Q: What is VA doing to correct the mistake?

A: We are working to identify the specific problems that caused the misidentification of Veterans records. We will ensure any future data extracts for similar outreach purposes are properly formulated and independently validated to prevent these types of problems in the future.

Q: Will Veterans be reimbursed for medical expenses incurred?
A: VA will reimburse Veterans who incurred expenses for medical evaluations conducted as a result of receiving an erroneous notification.

Q: What will VA do to prevent this from happening again?

A: As a result of this incident, VA is creating a more rigorous process that includes thorough and careful screening of the data, comprehensive review and approval process that will include involvement from our stakeholders before release of notifications letters.

WRAL-TV: N.C. Gulf War Veteran Among those who Receive VA's Errant ALS Letter

Written by Beau Minnick, WRAL-TV, Raleigh-Durham-Fayetteville, N.C

Web Editor: Kathy Hanrahan

(Henderson, N.C. - August 26, 2009) — Former Army Sgt. Samuel Hargrove, of Henderson, remembers the feeling he got when he opened a letter on Sunday from The U.S. Department of Veterans Affairs. It was a notification that he had been diagnosed with Lou Gehrig's disease.

“It really felt like the weight of the world had fallen upon my soul,” Hargrove said. “I started crying and wondering why no one had ever told this to me before.”

Like some other Gulf War veterans, Hargrove, 42, has some neurological problems. He suffers from chronic fatigue, fibromyalgia and narcolepsy.

After talking with other veterans in a resource center and online, Hargrove discovered he was among a group of veterans who received the letters erroneously.

With all the other symptoms he has, now Hargrove questions whether he has ALS, too. He wants the VA to pay for a test.

“I don’t want to see anyone else go through this kind of suffering from a mistake again,” Hargrove said.

VA spokeswoman Katie Roberts said the agency will individually apologize to those veterans who received the letters in error.

The veterans also will receive an explanation about how "this unfortunate and regrettable error" occurred and reassurances that the letters do not confirm diagnoses of the fatal neurological disease, she said. Roberts did not say whether the agency has determined how the error occurred.

VA employees were still thumbing through case files, trying to determine exactly how many veterans mistakenly received letters intended to inform sufferers of ALS, or Lou Gehrig's disease, of benefits available to them or surviving spouses and children.

"We understand we made a mistake," Roberts said. "We had every good intention.”

Roberts said the VA mailed more than 1,800 letters last week and has been notified by fewer than 10 veterans who received the letters in error. However, a Gulf War veterans group that provides information, support and referrals about illnesses to military members estimates at least 1,200 veterans received the letters by mistake.

Denise Nichols, vice president of the National Gulf War Resource Center, said panicked veterans in at least a dozen states have contacted her group.

ALS is a rapidly progressive disease that attacks the nerve cells responsible for controlling voluntary muscles. It is usually fatal within five years.

Veterans like Hargrove and former Air Force reservist Gale Reid in Montgomery, Ala., were initially suspicious of the letters, but went through the pain of not knowing whether they had ALS.

Reid said she incurred about $3,000 worth of medical expenses securing a second opinion from a civilian doctor. Reid hopes the VA will pay for the tests, but Roberts said she had to check on any reimbursements.

Jim Bunker, president of the veterans group, said someone at the VA told him the mistake was caused by a coding error in which veterans with undiagnosed neurological disorders were inadvertently assigned the code for ALS. The VA uses more than 8,000 codes for various diseases and illnesses, he said.

WATCH VIDEO
Local vet gets errant notice of ALS