Despite cries for progress, Congress sticks to modest VA reforms
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VA Secretary David Shulkin suggests he favors expansion of Agent Orange-related health care and disability compensation to new categories of ailing veterans but that factors like cost, medical science and politics still stand in the way.

Shulkin told the Senate VA Committee last week that he made recommendations to White House officials last year on whether to add up to four more conditions - bladder cancer, hypothyroidism, Parkinson's-like tremors and high blood pressure - to the list of illnesses presumed caused by exposure to herbicides during the Vietnam War.

"I have transmitted my recommendations to the Office of Management and Budget. I did that by Nov. 1," Shulkin said. "And we are in the process right now of going through this data."

At the same hearing, the VA chief was asked his position on "blue water" Navy veterans of the Vietnam War who also suffer from illnesses on the VA list but aren't eligible to use it to file claims for care and compensation.

They "have waited too long for this," Shulkin agreed, but then suggested the solution is blocked by medical evidence or the will of the Congress.

"I would like to try to find a way where we can resolve that issue for them, rather than make them continue to wait," Shulkin said. "I do not believe there will be scientific data (to) give us a clear answer, like we do have on the Agent Orange presumptive" list for veterans who had served in-country.

Vietnam veterans who served even a day in country who have illnesses on the list can qualify for VA medical care and disability compensation without having to show other evidence.

Shulkin said VA "recently" received the last report of the National Academy of Medicine, which found a stronger scientific association than earlier studies between certain ailments and herbicide exposure. VA has had the that report, Veterans and Agent Orange: Update 2014, for two years.

It was written by a committee of medical experts that reviewed medical and scientific literature on select ailments and herbicide exposure published from Oct. 1, 2012, through Sept. 30, 2014. Released in March 2016, the report found evidence to support raising the strength of association between herbicide exposure and bladder cancer and hypothyroidism. The report upgrades the link from "inadequate or insufficient" evidence to "limited or suggestive" evidence of an association.

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