VA's Agent Orange Examination Program:

Actions Needed To More Effectively Address Veterans' Health Concerns

HRD-83-6: Published: Oct 25, 1982. Publicly Released: Oct 25, 1982.

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In response to a congressional request, GAO reviewed Vietnam veterans' complaints regarding the Veterans Administration's (VA) Agent Orange program and related issues.

GAO found that, since 1978, more than 89,000 Vietnam veterans have been examined through VA services. Although the GAO veteran participant survey and investigation showed that VA examinations were more thorough than the veterans perceived them to be, GAO believes that VA could reduce dissatisfaction and health concerns by providing more timely and thorough examinations and by better dissemination of Agent Orange, health-related information to veterans. GAO reviewed disability compensation claim issues and noted that the unreliability of medical service records and the legal requirement for epidemiological studies of veterans exposed to Agent Orange suggest that the retroactive compensation period for claims should be changed.

Matter for Congressional Consideration

  1. Status: Closed - Not Implemented

    Comments: Congress passed legislation providing benefits to veterans exposed to Agent Orange or who were exposed to radiation from atomic tests or the occupation of Hiroshima and Nagasaki. The law does not provide for retroactive entitlement and Senate staffers advised that such a provision would not be passed for several years when the evidence regarding the effects of exposure are known.

    Matter: Congress should consider whether 38 U.S.C. 3010(g) should be amended to extend the retroactive compensation period for Agent-Orange-related disability claims to the date the initial claim was filed.

Recommendations for Executive Action

  1. Status: Closed - Not Implemented

    Comments: VA again stated in its 60-day letter that it does not plan to implement this recommendation. VA said that the registry is a valuable tool in VA oversight of Agent Orange activities.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should discontinue the computerized Agent Orange registry and maintain a list of veterans who have had Agent Orange examinations.

    Agency Affected: Veterans Administration

  2. Status: Closed - Implemented

    Comments: VA revised its forms.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should revise the exposure history form and use the standard VA physical examination and medical history forms to gather more thorough information during Agent Orange examinations.

    Agency Affected: Veterans Administration

  3. Status: Closed - Implemented

    Comments: VA issued a circular explaining environmental physician responsibilities.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should require environmental physicians to review all examinations records to ensure that examinations are thorough and documented.

    Agency Affected: Veterans Administration

  4. Status: Closed - Implemented

    Comments: VA issued a circular.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should direct VA physicians to document all findings for every factor described in VA Agent Orange program circulars for each examination.

    Agency Affected: Veterans Administration

  5. Status: Closed - Implemented

    Comments: VA emphasized this in conference calls and issuance of circulars.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should reemphasize to VA medical facilities the importance of providing examinations in a timely manner.

    Agency Affected: Veterans Administration

  6. Status: Closed - Implemented

    Comments: VA issued a circular.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should direct VA medical facilities to ensure that examining physicians are familiar with available information on Agent Orange and that they provide this information to all veterans examined.

    Agency Affected: Veterans Administration

  7. Status: Closed - Implemented

    Comments: VA issued a circular.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should direct VA medical facilities to inform veterans seeking Agent Orange examinations of the examination's limitations.

    Agency Affected: Veterans Administration

  8. Status: Closed - Implemented

    Comments: VA included the Agent Orange Program in the Systematic External Review Program.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should require VA medical facilities to include the Agent Orange examination program in the facilities' systematic internal review process.

    Agency Affected: Veterans Administration

  9. Status: Closed - Not Implemented

    Comments: VA did not concur with this recommendation and stated that any statistics that could be developed would be skewed due to the self-selected population.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should develop and analyze statistics on the kinds of skin problems, tumors, and birth defects identified in Agent Orange examinations and make this information available to veterans.

    Agency Affected: Veterans Administration

  10. Status: Closed - Implemented

    Comments: Implementing circular reissued.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should emphasize to VA medical facilities the importance of sending tissue samples taken from veterans who served in Vietnam to the Armed Forces Institute of Pathology.

    Agency Affected: Veterans Administration

  11. Status: Closed - Implemented

    Comments: VA issued a monograph in October 1985.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should develop a monograph on Agent Orange's potential for causing birth defects.

    Agency Affected: Veterans Administration

  12. Status: Closed - Implemented

    Comments: VA advised physicians to refer veterans to genetic counseling services.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should direct VA medical facilities to provide available information to veterans concerned about birth defects or to refer veterans to genetic counseling services for such information.

    Agency Affected: Veterans Administration

  13. Status: Closed - Not Implemented

    Comments: VA did not concur with this recommendation and stated that it is currently using a health status questionnaire to followup on veterans who have had Agent Orange examinations.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should direct VA medical facilities to followup with all veterans examined before January 1981 to ensure that they have been provided their examination results.

    Agency Affected: Veterans Administration

  14. Status: Closed - Implemented

    Comments: VA emphasized this during conference calls, Chief Medical Director's letter, and new pamphlets issued.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should direct all VA medical facilities to offer to send the Agent Orange pamphlet to all telephone callers interested in information about Agent Orange and advise callers when and where they can see the Agent Orange film.

    Agency Affected: Veterans Administration

  15. Status: Closed - Not Implemented

    Comments: Although VA agreed with this recommendation, it has not implemented it and discussions with the staff in the VA Consumer Affairs Service indicated it has no plans to implement this recommendation.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should use public service announcements to advise veterans of VA Agent Orange services.

    Agency Affected: Veterans Administration

  16. Status: Closed - Implemented

    Comments: VA is working with state veterans' affairs offices in distributing information and literature on Agent Orange services.

    Recommendation: The Administrator of Veterans Affairs, through the Chief Medical Director, should work with state veterans' affairs offices to advise veterans of available VA Agent Orange services.

    Agency Affected: Veterans Administration

 

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