This article was updated Wednesday, Aug. 11, at 4:14 pm.
The Veterans Affairs Department has adopted a standard identifier for all veterans to use in all its systems, including one to build electronic health records that will follow them from enlistment to death, VA's chief information officer said on Wednesday.
The identifier will apply to the department's entire universe of beneficiaries and will support data exchange for a joint project with the Defense Department called the Virtual Lifetime Electronic Record for active-duty military personnel and veterans, which President Obama announced in April 2009, CIO Roger Baker said during a press briefing.
The standard is based on a 2004 presidential directive that established common identification standards for all federal employees and contractors.
Baker said VA uses the Electronic Data Interchange Personal Identifier, which the Defense Enrollment Eligibility Reporting System employs to identify military personnel and contractors, to assign the universal identifiers to veterans in its health care and benefits information systems.
The 10-digit EDPI is part of a unique identification system for federal employees mandated by Homeland Security Presidential Directive 12 and appears on a bar code on the Common Access Card that Defense employees use to access military computer systems.
VA adopted the EDPI standard six weeks ago and Baker said it is a critical and "exciting" component for development of the Virtual Lifetime Electronic Record.
The move is "a great first step along the road to dealing with the many issues that have been practical barriers to reaching what everyone really wants for our servicemen and veterans: development of a lifetime electronic medical record," said Ed Meagher, director of health care strategic initiatives at SRA International and a former deputy CIO at VA.
Baker emphasized EDPI will be used internally in VA information technology systems, and the department will pair it with an existing identifier in its health care systems to identify patients.
A congressional source said the idea to use HSPD-12 and EDPI standards was originally included in the 2006 Veterans Identity and Credit Security Act, which Rep. Steve Buyer, R-Ind., introduced. But the House Armed Services Committee and the Office of Management and Budget had the language removed.
The Defense Enrollment Eligibility Reporting System, the central repository for military personnel data, uses EDPI as the primary identifier for everyone in the Defense Department, according to a March 28, 2008, memo from David S.C. Chu, who at the time was the Defense undersecretary for personnel and readiness.
Chu said Defense uses EDPI only for machine-to-machine transactions and the identifier "is not a number that is known to the individuals, and it is never intended that the EDPI be used outside of machine-to-machine transactions."
The Military Health System uses EDPI as a patient identifier for more than 9 million service health care beneficiaries, according to a presentation by Mary Dixon, director of the Defense Manpower Data Center, and Janine Groth, chief of the Defense enrollment eligibility reporting system division, which is part of the Defense Manpower Data Center. They spoke at an MHS conference in January.
Dixon and Groth said unique identifiers can never be changed or reissued, and can be cross-referenced to other identifiers such as Social Security numbers and Medicare identifiers.
They said EDPI can be used to unite information across a variety of Defense and VA systems, including joint indemnity repositories, the VA master patient index, the Defense clinical data repository and the AHLTA electronic health record system.
Genetic Screening for Health Care Risks at VA
The ability to determine a patient’s increased genetic risk of disease and provide appropriate health care is emerging as a component of personalized medicine in VA and is now available to VA clinicians for the first time in history. The VHA Employee Education System (EES) and Office of Research and Development (ORD) in partnership with the Office of the Secretary and the National Coalition for Health Professional Education in Genetics (NCHPEG) recently launched a continuing education course on genetics and colorectal cancer (CRC). This program is intended to provide VHA health care providers with the information and skills necessary to undertake genetic risk assessment for colorectal cancer, identify patients at increased risk, refer appropriate patients for genetic counseling and testing and target screening and management to the patient’s risk status. It is the first comprehensive educational tool on genetics of heritable colorectal cancer for a broad category of health care professionals in the United States.
|
Agent Orange: Blue Water Veterans
|
Veterans who served on open sea ships off the shore of Vietnam during the Vietnam War are sometimes called “Blue Water Veterans.”
In January 2009, the Supreme Court effectively let stand an earlier court ruling that requires a Veteran to have served on land or on the inland waterways of Vietnam in order to be presumed exposed to Agent Orange.
Some ships offshore also conducted operations on the inland waterways of Vietnam. Veterans are presumed exposed to Agent Orange if they served aboard these ships when the ships were on the inland waterways of Vietnam anytime between January 9, 1962 and May 7, 1975.
If not, Blue Water Veterans must show on a factual basis that they were exposed to herbicides during military service in order to receive disability compensation for diseases associated with Agent Orange exposure.
For help confirming service on the inland waterways of Vietnam or exposure to herbicides:
Institute of Medicine Review on Possible Agent Orange Exposure
VA has asked the National Academy of Sciences Institute of Medicine (IOM) to review the medical and scientific evidence regarding Blue Water Veterans’ possible exposure to Agent Orange.
A report should be completed and available by summer 2011.
IOM is evaluating:
- Historical background of the Vietnam War comparing Blue Water Navy, “boots on ground” combat troops, and Brown Water Navy (includes inland waters).
- Exposure levels among Blue Water Navy relative to ground troops in Vietnam or other contemporaneous ground troops deployed elsewhere (“era” Veterans).
- Comparative exposures for troops on the ground and troops aboard ships in the context of all possible routes of exposure, including herbicide “overspray,” and consumption of contaminated water and food.
- A wide range of potential herbicide and dioxin exposure mechanisms including potential concentrating toxics in drinking water; air exposure possibly from drift from spraying; food; soil; skin, etc.
- Comparative risks for long-term health outcomes comparing Vietnam Veteran ground troops, Blue Water Navy Veterans, and other “Era” Veterans serving during the Vietnam War at other locations (assuming relative herbicide and dioxin exposures can be assessed). This will be based on previous IOM Veterans and Agent Orange study conclusions*† on long-term health outcomes from herbicide exposure.
- Existing studies of Blue Water Navy Veterans for reported health outcomes.
VA Benefits for Blue Water Veterans
Eligible Veterans may receive the following VA benefits:
- Health care benefits: VA health care benefits are open to all Veterans. In order to receive health care benefits for diseases associated with Agent Orange exposure, Veterans who did not serve in Vietnam must show that they were exposed to herbicides during military service.
- Agent Orange registry health examination: A cost-free, comprehensive examination for eligible Veterans. Blue Water Veterans who served aboard ships that operated on the inland waterways of Vietnam are eligible.
- Disability compensation benefits: A monthly payment for eligible Veterans who have diseases associated with Agent Orange exposure. Blue Water Veterans who did not serve aboard ships that operated on the inland waterways of Vietnam must show on a factual basis that they were exposed to herbicides during military service in order to receive disability compensation for diseases associated with Agent Orange exposure.
- Other non-health care benefits: Home loans, vocational rehabilitation, education, and more
Contact VA about Benefits
By Telephone
- Toll-free Helpline: 1-800-749-8387 Press 3
- Health Care and Agent Orange Registry Health Exam: 1-877-222-8387 (Ask to speak to the Environmental Health Coordinator or Patient Care Advocate)
- Disability Benefits and Other Benefits: 1-800-827-1000
- TDD (for hearing impaired): 1-800-829-4833
In Person
VA Publishes Final Regulation to Aid Veterans Exposed to Agent Orange
VA Health Care and Benefits Provided for Many Vietnam Veterans
WASHINGTON – Veterans exposed to herbicides while serving in Vietnam and other areas will have an easier path to access quality health care and qualify for disability pay under a final regulation published tomorrow in the Federal Register by the Department of Veterans Affairs (VA). The new rule expands the list of health problems VA will presume to be related to Agent Orange and other herbicide exposures to add two new conditions and expand one existing category of conditions.
“Last October, based on the requirements of the Agent Orange Act of 1991 and the Institute of Medicine ’s 2008 Update on Agent Orange, I determined that the evidence provided was sufficient to award presumptions of service connection for these three additional diseases,” said Secretary of Veterans Affairs Eric K. Shinseki. “It was the right decision, and the President and I are proud to finally provide this group of Veterans the care and benefits they have long deserved.”
The final regulation follows Shinseki’s determination to expand the list of conditions for which service connection for Vietnam Veterans is presumed. VA is adding Parkinson’s disease and ischemic heart disease and expanding chronic lymphocytic leukemia to include all chronic B cell leukemias, such as hairy cell leukemia.
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 medical problems and their military service. By helping Veterans overcome evidentiary requirements that might otherwise present significant challenges, this “presumption” simplifies and speeds up the application process.
The Secretary’s decision to add these presumptives is based on the latest evidence provided in a 2008 independent study by the Institute of Medicine concerning health problems caused by herbicides like Agent Orange.
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.
More than 150,000 Veterans are expected to submit Agent Orange claims in the next 12 to 18 months, many of whom are potentially eligible for retroactive disability payments based on past claims. Additionally, VA will review approximately 90,000 previously denied claims by Vietnam Veterans for service connection for these conditions. All those awarded service-connection who are not currently eligible for enrollment into the VA healthcare system will become eligible.
This historic regulation is subject to provisions of the Congressional Review Act that require a 60-day Congressional review period before implementation. After the review period, VA can begin paying benefits for new claims and may award benefits retroactively for earlier periods. For new claims, VA may pay benefits retroactive to the effective date of the regulation or to one year before the date VA receives the application, whichever is later. For pending claims and claims that were previously denied, VA may pay benefits retroactive to the date it received the claim.
VA encourages Vietnam Veterans with these three diseases to submit their applications for access to VA health care and compensation now so the agency can begin development of their claims.
Individuals can go to a website at http://capwiz.com/vaocla/utr/1/IOIDNCCVLX/NLPQNCCWLM/5711381841 to get an understanding of how to file a claim for presumptive conditions related to herbicide exposure, as well as what evidence is needed by VA to make a decision about disability compensation or survivors benefits.
Additional information about Agent Orange and VA’s services for Veterans exposed to the chemical is available at www.publichealth.va.gov/exposures/agentorange.
Costs of aging vets concern deficit commission
RALEIGH, N.C. — The system that automatically awards disability benefits to some veterans because of concerns about Agent Orange seems contrary to efforts to control federal spending, the Republican co-chairman of President Barack Obama’s deficit commission said Tuesday.
Former Wyoming Sen. Alan Simpson’s comments came a day after The Associated Press reported that diabetes has become the most frequently compensated ailment among Vietnam veterans, even though decades of research has failed to find more than a possible link between the defoliant Agent Orange and diabetes.
“The irony (is) that the veterans who saved this country are now, in a way, not helping us to save the country in this fiscal mess,” said Simpson, an Army veteran who was once chairman of the Senate Veterans’ Affairs Committee.The Department of Veterans Affairs has also allowed Vietnam veterans to get money for ailments such as lung cancer and prostate cancer, and the agency finalized a proposal Tuesday to grant payments for heart disease — the nation’s leading cause of death.
Simpson declined to say whether the issue would become part of his work on Obama’s panel examining the nation’s debt. He looked to Congress to make a change.Sen. Daniel Akaka, a Hawaii Democrat who currently chairs the VA committee, said Tuesday he will address the broader issue of so-called presumptive conditions at a hearing previously set for Sept. 23.
The committee will look to “see what changes Congress and VA may need to make to existing law and policy,” Akaka said in an e-mail.“It is our solemn responsibility to help veterans with disabilities suffered in their service to our country,” said Akaka, who served in the Army Corps of Engineers during World War II.
“That responsibility also requires us to make sure limited resources are available for those who truly need and are entitled to them.”Virginia Sen. Jim Webb, a Democrat and Vietnam combat veteran, has also raised questions about the spending. The leading Republican on the committee, North Carolina Sen. Richard Burr, has not responded to several requests for comment on the topic in recent months.
Because of concerns about Agent Orange, Congress set up a system in 1991 to grant automatic benefits to veterans who served in Vietnam at any point during a 13-year period and later got an ailment linked to the defoliant. The VA has done that with a series of ailments with strong indications of an association to Agent Orange, including Hodgkin’s disease, soft-tissue cancers and non-Hodgkin’s lymphoma.
Other ailments have been added even though and Institute of Medicine review has found they only have a potential association and that they could not rule out other factors. Those maladies include prostate cancer, lung cancer and diabetes. The committee has said that, for diabetes, more powerful influences include family history, physical inactivity and obesity.
The AP found in reviewing millions of VA compensation records that diabetes is now the most frequently compensated ailment, ahead of post-traumatic stress disorder, hearing loss or general wounds. VA officials use a complex formula when awarding benefits and do not track how much is spent for a specific ailment, but AP calculations based on the records suggest that Vietnam veterans with diabetes should receive at least $850 million each year.
The VA also acknowledged in its heart disease rule Tuesday that it could cost billions more than initially anticipated. The initial projection was that the new ailments, mostly heart disease but also Parkinson’s disease and certain types of leukemia, would total $42.2 billion over 10 years.
But that was based on disease prevalence rates for the general population, not representative of the aging class of Vietnam veterans.VA used an age-adjusted formula in its latest proposal and estimated that it could cost some $67 billion in the next decade.
“It’s the kind of thing that’s just driving us to this $1 trillion, $400 billion deficit this year,” Simpson said. “It’s not that I’m an uncaring person, but common sense is the most uncommon thing in Washington.”
_______________________________________________________________________
Any man or woman who may be asked in this century what they did to make
life worthwhile in their lifetime....can respond with a great deal of pride and
satisfaction, "I served a career in the United States Navy."
Shipmates, Veterans & Military Retirees:
In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.
Reference: http://www.law.cornell.edu/uscode/17/107.shtml
YNCS Don Harribine, USN(ret)
|
|
