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| ADVOCATE NEWSLETTER | ||||
Volume 24 • Number 4 |
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Proposed Regulation Change Adds Illnesses to List of Diseases Subject to Presumptive Service Connection for Herbicide Exposure Well over 100,000 Veterans exposed to herbicides while serving in Vietnam and other areas will have an easier path to qualify for disability pay under a proposed regulation published by the Department of Veterans Affairs (VA) that adds three new illnesses to the list of health problems found to be related to Agent Orange and other herbicide exposures. The regulation follows Shinseki's October 2009 decision to add the three illnesses to the current list of diseases for which service connection for Vietnam Veterans is presumed. The illnesses are B cell leukemias, such as hairy cell leukemia; Parkinson's disease; and ischemic heart disease. The Secretary's decision is based on the latest evidence of an association with widely used herbicides such as Agent Orange during the Vietnam War, as determined in an independent study by the Institute of Medicine. Even though this is a proposed rule, VA encourages Vietnam Veterans with these three diseases to submit their applications for compensation now so the Agency can begin development of their claims and so they can receive benefits from the date of their applications once the rule becomes final. Comments on the proposed rule were accepted for 30 days. The final regulation will be published after consideration of all comments received. "We must do better reviews of illnesses that may be connected to service, and we will," Shinseki added. "Veterans who endure health problems deserve timely decisions based on solid evidence." Over 80,000 of the Veterans will have their past claims reviewed and may be eligible for retroactive payment, and all who are not currently eligible for enrollment into the VA healthcare system will become eligible. During the Vietnam War, the U.S. military used more than 19 million gallons of herbicides for defoliation and crop destruction in the Republic of Vietnam. Veterans who served in Vietnam anytime during the period beginning January 9, 1962, and ending on May 7, 1975, are presumed to have been exposed to herbicides. Used in Vietnam to defoliate trees and remove concealment for the enemy, Agent Orange and other herbicides left a legacy of suffering and disability that continues to the present. In practical terms, Veterans who served in Vietnam during the war and who have a "presumed" illness don't have to prove an association between their illnesses and their military service. This "presumption" simplifies and speeds up the application process for benefits. Other illnesses previously recognized under VA's "presumption" rule as being caused by exposure to herbicides during the Vietnam War are:
Additional information about Agent Orange and VA's services for Veterans exposed to the chemical are available at www.publichealth.va.gov/exposures/agentorange. The "Doc-Fix" Throughout the late winter and early spring of this year, Congress has enacted a series of temporary fixes, termed the "Doc Fix", to prevent automatic cuts in Medicare payment rates to doctors of 21 percent. To solve the problem over the long term would require some $240 billion which many Congressmen believe should be offset by spending cuts somewhere else. Other members of Congress believe the problem should be solved by other means. By extending temporary fixes Congress has more time to work on a more permanent solution. The reason the amount, 21 percent, is so large is that Congress has delayed solving the problem for several years, so the problem has gotten more expensive and more difficult to solve because they kept putting it off. Since TRICARE and TRICARE for Life payments and co-payments are based on Medicare rates, military beneficiaries of all ages have a stake in how this is resolved. Reductions in reimbursement rates for doctors and hospitals have resulted in more physicians and institutions refusing to take Medicare or TRICARE. One of the nation's premier medical facilities, Mayo Clinic, recently announced that it would no longer take Medicare. The State of Massachusetts, which has a statewide health care program similar to the recently enacted National Health Care Reform, is facing huge funding problems. Insurance companies in Massachusetts are starting to issue policies that largely bar patients from seeking care at some popular hospitals which are also expensive. We have already seen the same thing in some TRICARE areas which do not include some popular medical care providers in their networks. Some providers have stopped accepting new TRICARE patients because of reimbursement rates too low to cover the full cost of providing care. Secretary of Defense Bill Gates, and former DOD Secretary Donald Rumsfeld, as well as senior uniformed military officials, have all expressed concern with the cost of military health care. Indeed, DOD has tried to increase various TRICARE fees for the past several years only to be repeatedly blocked by Congress. The fact is, actions by the Department of Defense are responsible for some of the increase in the cost of care. The fact that we are in a war and are sending troops back for repetitive combat tours rather than increasing the size of the force is also responsible. Increasing the number of medical personnel and increasing the capability of Military Treatment Facilities to accept more beneficiaries rather than turning them away and forcing them to use commercial providers would save billions of dollars. Increasing fees and copayments will not do it. As one Defense official said, "increasing fees might save millions, increasing our MTF capability will save billions." National Commission on Fiscal Responsibility and Reform In addition to the co-chairs, former Senator Alan Simpson and former White House Chief of Staff Erskine Bowles, the President appointed Andy Stern, President, Service Employees International Union; Dave Cote, CEO Honeywell Corp: Ann Fudge, former CEO of Young and Rubican Brands; and Alice Rivlin, former Director of the Congressional Budget Office and Vice-Chair of the Federal Reserve. Senators on the Panel appointed by Majority Leader Harry Reid are: Richard Durbin, (Ill.); Max Baucus, (Mont.); and Kent Conrad, (N.D.). Senators appointed by Minority Leader Mitch McConnell are: Tom Coburn, (Okla.); Judd Gregg, (N.H.); and Michael Crapo, (Idaho). Many AFTEA members live in the states and districts of these commission members. We recommend you contact them. Let them know you are a constituent and that you expect them to protect your earned benefits. Relationship between TRICARE and Employer-Sponsored Group Health Coverage When Congress passes a law designed to address a social or economic need or problem, they typically write the broad outline of the law but then the appropriate federal regulatory agency then creates regulations necessary to implement the law. The Department of Defense has made the final rule regarding this provision and they made an exception which allows retired military employees to pay co-pays and deductibles and supplemental insurance on a pre-tax basis through a cafeteria plan. Although not an ideal fix, this provision does provide some relief for military retirees so that they can take advantage of the tax relief in a cafeteria plan. However, the final rule does still prohibit the employer from paying for the TRICARE health benefit. This has been a longstanding issue that AFTEA has led the fight on to get corrected. It is a gross injustice to discriminate against military retirees in this fashion. The original prohibition was so discriminatory that military retirees could not pay for their insurance on a pretax basis while other employees could. We are pleased that this change provides some relief and we will continue seeking full relief. National Health Care Reform There is still a lot we do not know about the National Health Care Law. In fact, all of the provisions of the bill won't even go into effect until 2014 and the regulations that implement the law will be worked on for the next six months. The reality is that we could be affected in unexpected ways. Many experts are continuing to study the law and we will keep you informed. This is going to be a turbulent election year and we urge all AFTEA members to keep in touch with their elected representatives. AMS has been informed that the Department of Defense is setting up the 50th Anniversary of the Vietnam War Commemoration Commission. The commission is congressionally mandated and chartered by the Department of Defense to plan and conduct this commemorative program which may include activities and ceremonies to achieve the following objectives: (1) To thank and honor veterans of the Vietnam War, including personnel who were held as prisoners of war or listed as missing in action, for their service and sacrifice on behalf of the United States and to thank and honor the families of these veterans. The Commission's activities will last until 2025 and will involve Vietnam War Commemoration programs conducted by the federal government, state and local governments, and international, commercial and private organizations. It is hard to believe that it has been almost 50 years since the start of the Vietnam War, a war that was perhaps the most controversial in our nation's history. But it is gratifying to know that this commemoration is being set up and that recognition will be given to all those who served in Vietnam and in the war effort. Whatever the opinions about that war, or any war, may be there is no denying that those who served, and serve now, deserve thanks and recognition from their fellow citizens. We need to remind all Americans that members of the Armed Forces do not make the policy. They simply take an oath to carry out the orders of their superiors and to serve the nation in the manner that is asked of them. * * * * * In his article elsewhere in this issue, Chuck Partridge tells about the new National Commission on Fiscal Responsibility and Reform that has been set up by the President and which has begun to meet to discuss ways to solve the massive federal budget debt. As Chuck mentioned, one of the members of that commission is Andy Stern, the former president of the Service Workers International Union. At the beginning of the deliberations of the committee, Stern stated that all entitlement programs, including Social Security, as well as the imposition of new taxes, should be on the table as the commission debates about what to do. Labor unions have traditionally been strong opponents of reducing Social Security and/or Medicare benefits as a way of dealing with the soaring federal debt, so Sterns' comments took many people by surprise. AMS believes that if a former union president says, in effect, that some reduction of Social Security ought to be considered as a partial solution, TRICARE and all military retirement benefits will also be "on the table." We are very concerned about what recommendations the commission will make and we will be monitoring it very closely. If we ask you in future issues of the Advocate to contact your Senators and Representative about the commission's recommendations, it is important that you take action. Your promised and earned military retirement benefits could be at stake. Landmark Bill to Care for Women Veterans and Provide Support for Veteran Caregivers Passes Congress and President Signs into Law House Veterans' Affairs Committee Chairman Bob Filner (D-Calif.) recently announced that the U.S. House of Representatives voted to approve S. 1963, the Caregivers and Veterans Omnibus Health Services Act, with a vote of 419-0. The bill creates a caregiver support program, improves health care services for America's women veterans, and expands the mental health services provided by the Department of Veterans Affairs (VA), among other things. Provides Caregiver Support Welcomes Home Women Veterans Prevents Veteran Homelessness Rural Health Care Increases Mental Health Care Access Other Veteran Health Care Provisions
"It is simply our duty as a Nation, when we put our men and women in harm's way, to care for them when they return," said Chairman Filner. "S. 1963 demonstrates America's commitment to the dedicated service members who have served in uniform and puts front and center the health care needs of veterans and their families. It is our pledge to them, that we have not forgotten the sacrifices they have made in defense of this country. We owe our veterans a debt of gratitude -- and this bill represents an understanding that the sacrifices of our veterans are shared among us all as Americans. Just a day after the bill was passed by the House, the Senate passed it by a unanimous voice vote. It was then sent to the President for his signature and has now become law. You may never have had a collision, or received a citation for speeding, or even paid a parking ticket. But no matter how well you drive, it always helps to keep in mind these four proactive pointers: Extend your vision. Rather than staring directly in front of your vehicle, focus on where it will be positioned 10 to 12 seconds down the road—the zone where an accident is more likely to occur. Scan the entire scene. Shift your focus every few seconds from the windshield to the rear and side mirrors to check for pedestrians, bicyclists, erratic drivers, construction, traffic congestion, oncoming trucks and motorcycles, and changing road conditions. Demonstrate your intentions. Whether using your signal to indicate a right or left turn, hazards to warn that you need to slow down because of a flat tire, or horn to assert your right of way, it always helps other drivers and pedestrians make their own appropriate decisions when they understand yours. Plan an escape route. Based on your speed and the proximity of other cars on the road, give yourself enough time and space to maneuver smoothly and stop if necessary. For instance, never tailgate and always estimate conservatively the time it will take to pass another car if you want to avoid a crash. This information brought to you by Liberty Mutual and the American Military Society. Our partnership with Liberty Mutual offers competitive rates and superior service to AMS Members. For more information please visit us at www.libertymutual.com/ams.
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