VA Secretary Eric Shinseki stood his ground before Congress, defending his decision to add three more illnesses to the list of 12 others presumed to be caused by exposure to Agent Orange herbicides during the Vietnam War.
Shinseki, testifying Sept. 23 before the Senate Veterans' Affairs Committee, said he decided to give presumptive condition status to ischemic heart disease (IHD), B-cell leukemia and Parkinson's disease because scientific evidence from nine medical studies "more than satisfies the positive association standard of the 1991 Agent Orange Act." The decision is one both fought for and supported by The American Legion.
"These decisions were not made lightly, but based on our duty to faithfully execute the purpose of the Agent Orange Act," Shinseki said. "Our actions will be viewed as an example of our seriousness and commitment to America's veterans."
A July 2009 report by the Institute of Medicine (IOM) strongly established a connection between exposure to Agent-Orange dioxins and the onset of Parkinson's, B-cell leukemia and IHD. While Shinseki found the report's evidence for these three illnesses credible and compelling, he told the committee that he decided against adding hypertension as another presumptive condition because the report's case, "was less compelling in my view and still did not establish a positive association. I believe that these decisions, in all four cases, were consistent within the law."
Reminding committee members that the Agent Orange Act opened the door to more proactive policies for veterans illnesses, Shinseki said that - once he became convinced the three illnesses were connected to herbicides used in Vietnam - his mandate was clear.
"The statute therefore directed that I establish a presumption of service connection, without regard to the projected costs or the existence of independent risk factors," Shinseki said, adding that such determinations were not made lightly. "They were made in accordance with the legal responsibilities assigned to me in the Agent Orange Act ... No other course of action would have met the intent of the law."
Once the IOM report was released, the law allowed VA only 60 days to decide whether new presumptions were warranted. After reviewing the report's evidence and analyses, and after consulting with legal and medical experts at VA, Shinseki determined, "that the evidence concerning B-cell leukemias, Parkinson's disease and ischemic heart disease met the positive association standard of the Agent Orange Act. Accordingly, VA proposed regulations to establish presumptions of service connection for those diseases."
Shinseki advised the committee that the exposure of U.S. forces to toxic chemicals and environments needs to be tracked much earlier. "Such tracking does not get easier or less complicated as time passes; early registration and surveillance of those exposed enables better treatment and rehabilitation, and allows us to make proactive decisions in mitigating future exposures.
"Early tracking, intervention, treatment, (and) rehabilitation equals better health for America's veterans. We must do better and we will," Shinseki said in closing.