VA Requirement for Diagnosis Determination May be Hindering Gulf War Illness, Other Claims

The following Military Times article about a new Congressional look at VA's claims adjudications practices exposes one of the most likely issues -- hidden until now -- that have negatively affected so many ill Gulf War veterans from obtaining appropriate service-connected disability ratings.


Readers are encouraged to contact Congressional representatives to encourage written support for this Congressional initiative from U.S. Senate Committee on Veterans' Affairs Chair Patty Murray (D-Wash.).


--Anthony Hardie
Madison, Wis.

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Complex VA rules for doctors may delay claims

By Rick Maze - Staff writer, Military Times publications

A key lawmaker says the Veterans Affairs Department may be unnecessarily delaying disability claims by heaping needlessly complex requirements onto the physicians who screen veterans.

When a veteran has multiple health problems and multiple symptoms, doctors are required to determine what portion of a symptom is caused by which disability — a practice that “may not be medically supported and may be unnecessarily delaying the processing of some claims,” Sen. Patty Murray, D-Wash., the Senate Veterans’ Affairs Committee chairwoman, wrote in a Nov. 16 letter to VA.

VA spokesman Josh Taylor had no comment on the specifics in Murray’s letter.

“The department received the letter today and is reviewing it and will provide a formal response,” he said.

The agency currently has more than 868,000 pending claims, 61 percent of which are more than 125 days old.

Unnecessary requirements — such as pro-rating symptoms by disability for veterans with multiple issues — could be part of the reason for delays, Murray said.

“I have heard time and time again from veterans who are frustrated with having to wait months, years and even decades for resolution of their claims and appeals,” she said.

Murray became aware of the requirement to apportion symptoms to specific disabilities after a VA inspector general review of the department’s Seattle regional office — cited as a location with many claims errors.

“Medical providers are being asked whether they can differentiate what portion of the symptom is caused by each diagnosis and to provide an opinion as to which overlapping symptom is attributable to each disability,” Murray said. “In cases where a medical provider fails to address this question, regional offices are required to return examinations to the provider, delaying a final decision on the claim.”

The inspector general report disclosed delays when physicians failed to apportion claims in their initial examination, requiring the reports to be returned for further work.

Murray said VA could be asking the impossible.

“Based on staff discussions with VA physicians, it appears that a medical provider cannot scientifically, with a high degree of certainty, attribute an overlapping symptom to one disability or another,” she said. “If a provider cannot say with a level of certainty greater than 50 percent that a particular symptom is due to only one of the overlapping symptoms, it calls into question the practice of asking a medical professional to answer this question.”

In her letter to VA Secretary Eric Shinseki, Murray said if the procedure is not necessary to resolve the claim, maybe it should be dropped.

“Returning an examination for failure to address a question that is not supported by medical science delays the final resolution of a claim and unnecessarily contributes to the claims backlog,” she said.

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Source: Military Times, Retrieved online 11/26/2011 at http://www.airforcetimes.com/news/2011/11/military-complex-va-rules-may-delay-claims-111611w/ 

  

Poor Sleep May Lead to Fibromyalgia

Since 1991, a primary health complaint of Gulf War veterans has been severely disturbed sleep.  Now, a new study suggests poor sleep may be a risk factor for developing Fibromyalgia, a chronic multi-symptom illness involving widespread and often debilitating pain.

Fibromyalgia is one of several conditions that are "presumptive" for veterans of the 1991 Gulf War.

--Anthony

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HealthDay:  Poor Sleep May Lead to Fibromyalgia in Women

Sleep problems linked to the painful condition, especially in middle age and beyond, study says

November 14, 2011 RSS Feed Print

MONDAY, Nov. 14 (HealthDay News) -- Sleep problems are associated with an increased risk of fibromyalgia in women, especially those who are middle-aged and older, a new study says.

Fibromyalgia is a chronic musculoskeletal pain condition that affects more than 5 million adults in the United States. Women account for up to 90 percent of people with fibromyalgia, which typically begins in middle age.

Previous research has found that insomnia, nighttime awakening and fatigue are common symptoms experienced by fibromyalgia patients, but it wasn't known if sleep problems contribute to the development of fibromyalgia.

Norwegian researchers enrolled 12,350 healthy women, 20 years and older, with no musculoskeletal pain or movement disorders and followed them for 10 years. At the end of that time, 327 (2.6 percent) of the women had developed fibromyalgia.

The study found that the adjusted relative risk of fibromyalgia among women who often or always had sleep problems was 5.41 among those older than 45 and 2.98 among those ages 20 to 44.

The study appears online Nov. 14 in the journal Arthritis & Rheumatism.

"Our findings indicate a strong association between sleep disturbance and fibromyalgia risk in adult women," Dr. Paul Mork, from the Norwegian University of Science and Technology, said in a journal news release. "We found a dose-response relation, where women who often reported sleep problems had a greater risk of fibromyalgia than those who never experienced sleep problems."

While the study found an association between poor sleep and fibromyalgia, it did not demonstrate a cause and effect.

Further research is needed to determine whether early detection and treatment of sleep problems can reduce fibromyalgia risk in women, the researchers said.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about fibromyalgia.

In Honor of Michael Woods

Dear friends and fellow veterans advocates, researchers, clinicians, and government leaders and administrators,

It is with deep regret that I send you this email to inform you that yesterday, on Veteran's Day 11-11-11, fellow Gulf War veteran, lifelong veterans advocate, friend, and veteran brother Michael Woods of Shelbyville, Kentucky lost his long, courageous battle with 20 years of Gulf War related health issues. 

Many of you will remember him from his many years of Gulf War Illness advocacy, including as the Executive Director of the National Gulf War Resource Center (NGWRC) between 2000 and 2004. 

Others will remember Michael for his captivating testimony before Congress on Gulf War health issues, when he informed Congress that he had been prescribed "Obecalp" by the VA for his GWI health issues --  "placebo" spelled backwards.

Michael left behind his loving wife Jessica, 4 beautiful children, both parents, all his brothers and sisters, many other loved ones, and countless fellow Gulf War veteran friends who continue Michael's legacy fighting for desperately needed medical research and treatments for the 1-in-3 Gulf War veterans who, like Michael, have remained seriously ill since their 1991 Gulf War service. 

A beautiful obituary and memorial service information is here:  http://web1.lovinghonors.com/cgi-bin/CompanyInternal?stdout+116+shannonfuneralhome.com+102+4+2151

For those considering flowers or other similar gestures of kindness, please instead consider a donation to help defray the large medical bills left over for Michael's final health care.  To date, $1,103 of his family's needed $10,000 has been raised.  Donations can be made online at: https://apps.facebook.com/fundrazr/activity/42c2ca92c71047818d4cdefe0c807d26

Michael was released to home hospice on November 10th -- his 43rd birthday -- the day before he died. 

Anthony




Anthony Hardie
Madison, Wis.
Email:  anthony.d.hardie@gmail.com

• Publisher and Principal Author, 91outcomes.com: Health & News for Gulf War Veterans; Republished to http://www.veteransnewsnow.com/author/hardie
• Member, U.S. Department of Veterans Affairs (VA) Research Advisory Committee on Gulf War Veterans' Illnesses (RAC-GWVI):  www.va.gov/RAC-GWVI/Members_and_Consultants.asp
• Member, U.S. Department of Veterans Affairs (VA) Gulf War Steering Committee
• Consumer Reviewer, U.S. Department of Defense (DoD) Congressionally Directed Medical Research Program (CDMRP) -- Gulf War Illness Research Program Integration Panel:  http://cdmrp.army.mil/gwirp

DU in Bosnia: Quebec veteran ends hunger strike

Quebec veteran ends hunger strike

 Postmedia NewsNovember 8, 2011

QUEBEC - A former Quebec soldier ended his hunger strike Tuesday after reaching a deal with Veterans Affairs Minister Steven Blaney to help ailing war veterans.

Pascal Lacoste, who suffered two temporary drops in blood pressure Monday, was taken to the hospital Tuesday after he emerged from Blaney's Levis, Que. riding office with a deal in hand.

The 38 year old claims he was poisoned by depleted uranium while serving in Bosnia in the 1990s.
He had vowed to stop eating until the government accepted his requests for decontamination treatments and his demand to recognize soldiers could have been contaminated by uranium.

Since beginning his hunger strike Saturday, Lacoste has had nothing to eat or drink, only taking the occasional medication.

Jean-Christophe de le Rue, spokesman for the minister, said Blaney offered to create within 30 days an advisory board to study veterans' health issues, starting with uranium. Lacoste consulted with veterans who are supporting his cause and decided to take the deal.

``The minister also offered to arrange medical assistance for him and extended that offer to all veterans,'' de le Rue said, noting Blaney is ``very happy'' Lacoste is not endangering his health anymore.

Lacoste said he has suffered from a degenerative neurological condition, infertility and chronic pain for more than a decade.

On a Facebook page supporters claimed ``victory!'' after the deal was announced.

Gulf War Illness Washington Update

(91outcomes.com) -- There's lot happening right now on behalf of veterans of the 1991 Gulf War, and after years of missteps, most of it is now squarely aimed at improving the health and lives of Gulf War veterans.



However, the U.S. Senate has taken action that would deeply fail our ailing Gulf War veterans, and unless action is taken by the Senate soon, Gulf War veterans suffering from Gulf War Illness (about one out of every three, based on current estimates) will lose their best hope for medical treatments to improve their health and lives.



The updates below are a brief overview of what's happening now, and while the Senate action is upsetting and best, the other reports are more encouraging.



As always, as a fellow permanently service-disabled Gulf war veteran representing Gulf War veterans in many of these arenas, please leave your comments -- I carefully read them all and echo them to anyone who will listen (smiling) in our deliberations in Washington and beyond.






The RAC



The Congressionally chartered U.S. Department of Veterans Affairs (VA) Research Advisory Committee on Gulf War Veterans' Illnesses (RAC-GWVI) has announced its next meeting for January 31st and February 1st, 2012 in Washington, DC.



The new meeting dates will allow for a coordinated attendance for the RAC-GWVI, the VA Gulf War Steering Committee, and members and VA Office of Research and Development Office regarding the revised VA Gulf War Research Strategic Plan.



This meeting is open to the public.  And, as the meeting date gets closer, instructions will be provided on how to call in for those who wish to attend via teleconference -- at no charge to you, of course.

As a RAC member, I'll be part of this meeting.  Please feel free to share your comments and questions with me in advance so I can represent you the best I can at this meeting.






The Future of CDMRP



The acclaimed Gulf War Illness Research Program funded as part of the Congressionally Directed Medical Research Programs (CDMRP) remains at serious risk of being eliminated as a stand-alone program due to Congressional action by the United State Senate.



The CDMRP's Gulf War Illness program is focused solely on "improving the health and lives" of those affected by Gulf War Illness, which is estimated to affect 250,000 veterans, or more than one-third of all veterans of the 1991 Gulf War.



The small but highly efficient and effective CDMRP has found the only viable treatment, CoQ10, which has been proven to help alleviate some GWI symptoms.  



In mid-September, the U.S. Senate's appropriations committee voted to support a deal that included elimination of the CDMRP programs for Gulf War Illness, ALS, Multiple Sclerosis (MS), and a number of other important CDMRP programs not duplicated anywhere else in government.  



Some newer members of Congress are reported to believe that the program is duplicative of other programs, but that is patently false.  In fact, for Gulf War Illness research, there are only two current federal "pots of money" where medical research is funded:  VA, and CDMRP.  



To qualify for VA's medical research funding, only VA staff qualify, so the entire rest of the research world in universities, not-for-profit research institutes, and others cannot qualify.  Furthermore, most of VA's Gulf War Illness research to date has not been multi-disciplinary or multi-instutional -- the current trend in medical research.  And most importantly, VA's hundreds of millions of dollars in GWI medical research has yet to produce even a single viable treatment for Gulf War Illness.



Unless the Senate takes specific action on the floor to restore the CDMRP Gulf War Illness program -- the only program in the history of Gulf War Illness to produce a treatment that helps reduce some GWI symptoms -- the Senate's final bill would include the current provision that eliminates it, along with the ALS and MS programs.



Furthermore, a minimum of $25 million in funding is needed this year to pay for the three multi-disciplinary, multi-institution consortia projects that are currently funded for start-up costs only.  If $25 million is not provided by Congress for this program, the consortia will die on the vine.



To not maintain a standalone DoD medical research program aimed at developing treatments for the chemical-induced Gulf War Illness medical disorder cuts at the heart of military medical readiness, and says to our Gulf War veterans, "You don't matter anymore."

Calls, emails, and letters are desperately needed now to call for a restoration of funding of these critical programs, and funding of the Gulf War Illness CDMRP program at $25 million.






CDMRP Update



The CDMRP's integration panel, of which I've been a member since the program began in December 2006, will meet via teleconference in early December.  We'll be reviewing the final research proposals submitted for this year's research funding.



Gulf War veteran and Gulf War Illness patient Chris Kornkven, who recently moved with his beautiful family to Colorado, also serves on the panel and provides a wealth of knowledge from his nearly 20 years experience in Gulf War veterans' advocacy.  



From earlier this year, many of them looked quite promising and are expected to lead to additional treatments and help in improving Gulf War veterans' lives and well being.


Regrettably, the meetings cannot be open to the public (or medical researchers) because they involve procurement sensitive information.  However, as Gulf War Illness patients and active advocates, Chris and I both work very hard to represent the Gulf War veteran community.  As always, please contact me about anything related to the CDMRP -- including how GWI may be affecting women or veterans with particular racial backgrounds -- and I'll continue to do my best to represent all of our community's needs.






VA Gulf War Task Force



The VA has recently released the new  report from its internally staffed Gulf War Task Force.  The report can be found at http://www.va.gov/opa/publications/docs/Draft_2011_GWVI-TF_Report.pdf.

The GWTF was created based on the recommendations of the Gulf War veteran community and the RAC-GWVI.

“To ensure we are tracking the needs of our Veterans, we want to get feedback from Gulf War Veterans on this draft report,” said Gingrich. “Their feedback is critical to our efforts to understand and serve their specific needs. Therefore, we hope they take advantage of one of the different opportunities to provide feedback that we have created for them," said the Chairman of the Gulf War Veterans’ Illnesses Task Force is John R. Gingrich, chief of staff at VA, a retired Army officer who also served in the Gulf War.



Public comments on the proposal are a very important part of the VA's review process, and anyone -- veteran, family member, researcher, member of the public -- can provide their comments.  

While Gulf War veteran advocates have been encouraging VA to include Gulf War veteran representation on the committee, VA leadership does strongly encourage public comment through review of the GWTF's internally created recommendations and reports.



Your public comments are due to the Federal Register no later than Nov. 21, 2011.  The link to the Federal Register is http://www.regulations.gov/#!documentDetail;D=VA-2011-VACO-0001-0239.

In addition, VA recognizes that a great number of Gulf War Veterans use the Internet on a daily basis to share their ideas and concerns, so VA has also created a public discussion board on the seven recommendations at: http://vagulfwartaskforce.uservoice.com/.



To view the report without making recommendations, please visit VA’s website at http://www.va.gov/opa/publications/Draft_2011_GWVI-TF_Report.pdf.



Because of the requirement that RAC-GWVI recommendations be discussed in a public meeting, there will be no official RAC-GWVI comment, so your individual actions are strongly encouraged.






VA Gulf War Steering Committee



The VA's Gulf War Steering Committee will be meeting next in early December.  Much of the meeting is expected to include reviewing the work of a number of subcommittees that have been working hard in the background to flesh out the first-ever VA Strategic Plan for Gulf War Illness Research that will be focused like a laser on improving the health and lives of Gulf War veterans.



The GWSC is composed of members of the RAC-GWVI, and VA's National Research Steering Committee (NRSC), which helps oversee and provide direction for all of VA's vast array of medical research efforts.



The GWSC's deliberations are not currently open to the public.  As the sole Gulf War veteran on the panel otherwise composed of highly distinguished scientists, you can be assured that I do my best to represent the Gulf War Illness patient community.






Medical Research Oriented Gulf War Illness Patient Needed



If you are a Gulf War veteran suffering from chronic multi-symptom illness not otherwise diagnosed as some recognized medical condition like ALS or MS, you have proof you served in theater in the 1991 Gulf War, and you can read and understand medical research, please contact me for an opportunity to serve your fellow veterans.  



You'll spend a few days reviewing medical research proposals and providing clear written and verbal comments about each proposal as an integral part of the review process.  



If you have a medical or scientific background or simply have been around medical research enough to understand it, and you understand firsthand what it's like being a Gulf War Illness patient, this is an exciting and rewarding opportunity to help your fellow Gulf War veterans.



You must have high integrity, and be willing to abide by a confidentiality agreement to protect the procurement information submitted by medical researchers from around the world.



You'll be compensated for your time, and all travel is covered in full.



Think you have what it takes? Interested in helping your fellow ill Gulf War veterans?  Please contact me at admin@91outcomes.com.






Conclusion

Even if you have already, please again take the time to contact both of your U.S. Senators to demand they provide $25 million in funding for the CDMRP Gulf War Illness research program this year.



Again, to not maintain a standalone DoD medical research program aimed at developing treatments for the chemical-induced Gulf War Illness medical disorder cuts at the heart of military medical readiness, and says to our Gulf War veterans, "You don't matter anymore."



If you need more information on Gulf War Illness, including to provide to your medical care provider, please take a moment to visit the newly created Association for Gulf War Illness, at www.AGILE.gs.  

Thank you to all my fellow Gulf War veterans, for your service and for your sacrifice in doing the best you can to grapple with an array of life-changing and often debilitating medical symptoms that are the price each of us has paid for serving our nation.



Anthony Hardie
Madison, Wis.