VA to Intensify Gulf War Illness Outreach, Care

By Donna Miles
American Forces Press Service

April 1, 2010 - Veterans Affairs Secretary Eric K. Shinseki yesterday announced promising news for veterans of the Persian Gulf War experiencing the broad range of symptoms referred to as Gulf War Illnesses. Acting on recommendations from a task force he stood up to identify gaps in service, Shinseki said VA plans to reconnect with veterans who deployed during the Gulf War in 1990 and 1991 to ensure they get the best information and care possible.

As part of that outreach, VA's Gulf War Veterans' Illnesses Task Force recommended improved data-sharing with the Defense Department to notify veterans of potential exposures, monitor their long-term health and provide additional follow-up.

The task force also recommended that VA strengthen training for clinicians and claims processors so they're better postured to diagnose, treat and process disability claims related to Gulf War Illnesses, and reenergize its research and medical surveillance efforts.

The task force's report will redefine how VA addresses the concerns of veterans deployed during the Gulf War, Shinseki said. "Our mission at VA is to be advocates for veterans," he said. "This report's action plans provide a roadmap to transform the care and services we deliver to Gulf War veterans."

The new recommendations come on the tail of a VA proposal announced last month to presume nine specific infectious diseases to be service-connected for anyone who served in Southwest Asia after Aug. 2, 1990, or in Afghanistan after Sept. 18, 2001.

That ruling, once adopted, will impact veterans who deployed to Iraq and Afghanistan. It will relieve those suffering from the designated diseases from the burden of proving their ailments are linked to service in the Persian Gulf or Afghanistan to receive VA health care and disability payments.

The nine diseases are: brucellosis, Campylobacter jejuni, Coxiella burnetii (Q fever), malaria, Mycobacterium tuberculosis, nontyphoidal Salmonella, Shigella, visceral leishmaniasis (kala-azar) and West Nile virus.

During an interview with American Forces Press Service, Shinseki called the proposed ruling a positive step in taking care of Gulf War veterans suffering numerous symptoms and diagnoses yet to be pinpointed to any specific exposure.

"We can't historically go back and decide what actually caused [Gulf War Illness]," he said. "We spent $350 million trying to find the cause, and we haven't arrived at a clear answer."

Rather than simply waiting for researchers to come up with a cause-and effect solution, Shinseki pressed VA to come up with a plan to compensate affected veterans now.

"My request was, 'Can we agree that something happened?'" he said. "We have enough evidence here, symptomatically, that something happened. It may be a combination of things. We may never be able to answer exactly what caused this.

"But we can deal with the problem,' he said. "So let's take care of people."

Shinseki took a similar approach to Agent Orange, a defoliant used during the Vietnam War that many veterans blame for causing a variety of illnesses and diseases.

VA previously presumed 12 diseases to be service-connected based on Agent Orange exposure. In October, Shinseki proposed adding three more diseases to the list: hairy-cell leukemia and other B-cell leukemias, Parkinson's disease and ischemic heart disease.

Shinseki said he based his decision on a report by the National Academy of Science's Institute of Medicine citing compelling new evidence of a connection between the three illnesses and Agent Orange exposure.

"That was not an independent decision by the VA," Shinseki emphasized. "The Institute of Medicine is designated by Congress as the impartial determiner of whether or not there is sufficient evidence to make the decision like the one I made.... And they gave me enough information for me to say, 'I can see the tie.' So the decision was made."

Shinseki, a former Army chief of staff and Vietnam veteran, had long criticized past practices that put the burden on veterans to prove that the variety of illnesses many suffered was linked to Agent Orange exposure. Too often, he said, this created an adversarial relationship between VA and veterans.

"It was important to clearly let the Vietnam veterans know that they have not been forgotten," he said. "We are dealing with our responsibilities here."