More than 84,000 Vietnam veterans afflicted with heart disease, Parkinson's disease or B-cell leukemia are drawing disability compensation today thanks to a decision by Secretary of Veterans Affairs Eric Shinseki to expand the list of ailments presumed caused by exposure to herbicides, including Agent Orange, used during that war.
Another 74,000 veterans have claims pending, and will only need to show VA that they set foot in Vietnam and have one of the diseases added last year to the list of Agent Orange "presumptive" conditions.
Though these payments comfort veterans and their families, they have upset some Republican senators who argue they are "unfair" to fellow veterans and taxpayers, and drive up VA compensation claims at a time when budgets are tightening and needs are expanding for new veterans.
These senators argue the Agent Orange Act of 1991 is flawed, providing too much authority to the VA secretary and allowing compensation awards based on a mere "association" between a disease and herbicide exposure rather than evidence that exposure "caused" the ailments.
"We are transferring a half million dollars to veterans under this decision by Secretary Shinseki for people who weigh 350 pounds, smoke three packs of cigarettes a day, and have hypercholesterolemia because they will not take their medicine," Sen. Tom Coburn, R-Okla., complained to colleagues during floor debate on his recent amendment to tighten the law.
"We are saying the reason they have heart disease is because at some point in time they were in Vietnam" and their disease meets the law's criteria of being associated with herbicide exposure.
Coburn in late July sought to change the law to block more conditions from being added to VA's list of presumptive diseases for exposure to Agent Orange unless medical science can show a causal effect and veterans can prove they were exposed to the herbicide.
Coburn's amendment to the Military Construction and Veterans' Affairs Appropriations Act of 2012 was tabled on a motion from Sen. Patty Murray, D-Wash. The vote was 69-to-30 with 29 Republicans supporting Coburn.
Though he lost this vote, Coburn will continue to try to narrow the Agent Orange law and trim back authority of the VA secretary for expanding the list of presumptive diseases, said his press aide, Becky Bernhardt.
Coburn's amendment would not have affected the current list of presumptive diseases, including conditions added last year. That wasn't clear from his rhetoric during floor debate. Coburn noted that in 2006 the Institute of Medicine found no positive association between exposure to Agent Orange and heart disease. By 2008 it had found a positive association "but absolutely no causation. There is a big difference. ... On that basis, the secretary committed this country to make payments to people for disabilities not associated with their service. ... With a limited budget going forward, if we are paying for disabilities that are not associated with service, that means we are going to have less money available for those veterans who do have a disability."
Arizona Sen. John McCain, ranking Republican on the armed services committee, endorsed Coburn's amendment. McCain had co-sponsored the Agent Orange Act of 1991 believing the herbicide had harmed the health of many thousands of veterans. But the VA secretary "has now expanded the eligibility to the point where it is beyond any scientific evidence that compensation would be required," McCain said.
He noted that heart disease "is the leading cause of death in America today and has been so for decades." Yet any Vietnam vet with the disease now can be awarded compensation at a potential cost to VA of up to $42 billion by 2020 "without what appears to be a direct connection to Agent Orange." There are too many legitimate needs "for veterans of wars to come" to allow this "open-ended expenditure of taxpayers' dollars."
Sen. Jim Webb, D-Va., a Vietnam veteran like McCain, voted with fellow Democrats to table the amendment. But Webb, who serves on the veterans' affairs committee, later released a statement saying he agreed with Coburn that the 1991 law's associative link between illnesses and exposure to Agent Orange is too vague and gives too much discretion to the secretary of veterans affairs.
"This discretionary power has been increasingly widened over time, impacting hundreds of thousands of veterans and billions of taxpayer dollars," Webb said. "Legislation enacted 20 years ago under the assumption that it would be applied to a very narrow set of illnesses now allows presumptive service-connection for such age-related maladies as Type II diabetes and chronic heart disease."
He asked VA Committee Chairman Murray to hold a hearing to consider legislation to reform the 1991 law.
Murray expressed no support for such a hearing in her motion to kill the amendment, arguing that Coburn made "a compelling case for saving money" but gave no evidence Agent Orange did not cause the conditions faced by these veterans.
Veterans' groups vigorously attacked the amendment.
"Congress, in part, settled on this mechanism because it was nearly impossible for Vietnam veterans to prove that their exposure to Agent Orange caused their health conditions," said John Rowan, National President of Vietnam Veterans of America. Coburn's change "would essentially mean that benefits due to Agent Orange exposure would be out of reach" on additional diseases.
Tim Tetz, legislative director for the American Legion, said the law remains "fair and nonpolitical. We think that's the model for environmental exposures as we go forward. ... We applauded it then, and we continue to applaud it today for creating an objective, scientific-based standard" which recognizes very poor record-keeping on herbicide exposure during the war.